




\ 


I 































Bernarr Macfadden as he was when this picture was taken 
at 56 years of age. 







F 


Constipation 

Its Cause, Effect 
and Treatment 


BY 

BERNARE MACFADDEN 

Author of Macfadden’s Encyclopedia of Physical 
Culture, Eating for Health and Strength, Strength¬ 
ening the Eyes, Hair Culture, Manhood and Marriage, 
The Miracle of Milk, Vitality Supreme, and other 
works on Health and Sex 


NEW YORK 

MACFADDEN PUBLICATIONS, Inc. 

1924 




■RO&e i 

H\5 


Copyright 1924 

By MACFADDEN PUBLICATIONS, Inc. 
New York 

In the United States, Canada and Great Britain 


©C1A8085I0 


"Printed in the United States of America 


OCT 3U i^£4 


PREFACE 


^FHE organ commonly known as the large 
bowel, large intestine or colon, performs 
the important and indispensable function of 
removing from the body not only its solid 
waste products which are derived from indi¬ 
gestible residues of the food consumed, but 
also metabolic wastes, epithelium and bacteria. 
These materials if not disposed of would re¬ 
main to clog and poison the body. 

Obvious as is the importance that a healthy 
functioning of the bowel be maintained, there 
is yet no disorder so prevalent as the condition 
called constipation. This is, in effect, a break 
down from some cause in the sewerage system 
of the body, resulting in retardation of the 
passage and undue retention of the solid waste 
products in the colon. Just as an inade¬ 
quate sanitary arrangement for disposal of 
sewage in a city would react injuriously to the 
health of those living in the community, some¬ 
times breeding and spreading serious disease,, 
iii 


Preface 


so if the sanitary mechanism which does the 
work in an individual body is defective there 
may be disturbances in the general health of 
the individual. 

Constipation until comparatively recently 
has been treated as if it were a distinct disease 
in itself; but it is merely a symptom, found in 
a great variety of diseases and disorders, 
though as the causes and conditions producing 
this symptom are numerous and varied, the 
correction of the symptom itself is so complex 
as not to be solved merely through the use of 
drug laxatives. It is such an universally prev¬ 
alent condition of abnormal functioning that 
few, if any, escape trouble from it throughout 
their lives. Ever since the days of Hippo¬ 
crates writers on subjects medical and hy¬ 
gienic have emphasized the harm that results 
from an abnormal retention of waste matter 
in the intestines. They have recognized the 
prominent position that the polluted digestive 
tract holds in the production or aggravation 
of both minor and grave disorders, and have 
urged that the intestinal tract be kept in a 
state of as complete cleanliness as possible, in 
order both to prevent and to cure disease. 

iv 



Preface 


Still other writers have expressed their belief 
that the importance of constipation as a factor 
for disturbing health or aggravating disease 
has been greatly over-estimated. My obser¬ 
vation and experience, which have not been 
inconsiderable, have led me to believe that, 
while constipation may exist in a few cases 
without causing a vital disturbance of health, 
usually the condition produces a marked low¬ 
ering of physical and mental efficiency, with 
frequently definite disease conditions follow¬ 
ing as a direct result. 

I have considered this subject in consider¬ 
able detail in this book, and any one suffering 
from constipation would do well to read and 
ponder every word. But there will, no doubt, 
be many who are anxious to start treatment 
and who will wish to gain a general grasp of 
the subject before considering it in all its de¬ 
tails, so that they can proceed with the proper 
measures at once. For these persons I would 
suggest that they first read the sections that I 
have enumerated in the next paragraph, and 
then as soon as may be they can consider the 
details. 

In Chapter II, read under the following 



Preface 


headings: “Definition” on page 17; 
“Normal Stools” on page 18; “Acute 
Constipation” on page 23, and “Chronic 
Constipation” on page 27. 

In Chapter III, read the “Summary” on 
pages 100 to 103. 

In Chapter IV, read under the heading 
“Symptoms” on page 104, and then read 
all the headings throughout the chapter 
but omit the details until later. 

In Chapter V, read under the following 
headings and subheadings: “Treatment” 
on page 139; “Habit Formation—Solici¬ 
tation” on page 141; “The Importance of 
Drinking Water” on page 145; and the 
entire sections on “Dietetic Treatment,” 
“Exercise,” “Hydrotherapy” and “Sum¬ 
mary.” 

For those who are particularly interested in 
the subject of constipation in children I would 
suggest that they first read the section under 
this heading, which is on page 273. 

Believing that in the majority of people 
health cannot be at its highest when intestinal 
sluggishness exists, also that eighty per cent 
of all cases of constipation can be corrected by 

vi 



Preface 


diet alone and that practically all of the re¬ 
maining twenty percent can be corrected by 
a combination of diet and other simple hy¬ 
gienic measures, this volume has been pre¬ 
pared as another unit of my very valuable 
health library. My direct and indirect con¬ 
tact with and advice to suffering mankind has 
given me full confidence that the suggestions 
here presented, if put into practice, are capa¬ 
ble not only of removing the one symptom of 
constipation but also many other symptoms 
and conditions, whether they be directly or 
indirectly associated with the constipation. 



vii 









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TABLE OF CONTENTS 


CHAPTER PAGE 

Preface .iii 

I. The Alimentary Canal ... 1 

II. The Nature of Constipation . . 17 

III. Causes of Constipation. ... 30 


IV. Symptoms, Results and Effects . 104 


V. Treatment 


139 









Constipation 

chapter I 

The Alimentary Canal 

^THE bowels are the sewerage pipes of the 
human body and their functioning is 
effected and regulated by a combined muscu¬ 
lar and nervous interaction. 

In order to understand more fully the na¬ 
ture of constipation, it will be of advantage 
to the reader to have presented a brief descrip¬ 
tion of the anatomical relations of the various 
parts of the alimentary canal—that part of 
the body which has to do with the digestion of 
food, with the alteration of this food into suit¬ 
able substances to perform various functions 
when absorbed into the body, and, to a very 
considerable extent, the elimination of waste. 
A brief description of the arrangement and 
the functions of these various parts will also 
be valuable in helping one to understand the 
l 


Constipation 


theory of the causes, the local and systemic 
effects, and the correction of constipation. 
Each part of the alimentary tract has a defi¬ 
nite function to perform, and if these func¬ 
tions, in whole or in part, are affected in any 
way so as to suppress, retard or obstruct them, 
constipation will most probably result. 

The Mouth—Mastication. When food is 
taken into the mouth it should receive here 
much of its preparation for digestion and ab¬ 
sorption. The teeth are provided, constructed 
and arranged for grinding food. This food 
must be masticated or triturated to such a de¬ 
gree of fineness that the saliva and digestive 
juices of the stomach and intestines may reach 
every particle. Lack of adequate mastication 
or, as it is called, the bolting of food, is a very 
common cause not only of constipation but of 
numerous other disturbances of the alimen¬ 
tary canal. The act of mastication is com¬ 
pletely under the control of the will; conse¬ 
quently there is no excuse for a lack of 
sufficient preparation of food in the oral cavity 
for digestion. Beyond this, every function of 
the alimentary canal is involuntary and be¬ 
yond the control of the will, except the very 



The Alimentary Canal 


final function of waste evacuation. This latter 
may be entirely voluntarily produced or sup¬ 
pressed, though in normal conditions it is, to 
a considerable extent, a combination of vol¬ 
untary and involuntary acts. It is undoubt¬ 
edly just this voluntary control of the two 
ends of the digestive tube that is responsible, 
to a large extent, for much of our wide-spread 
constipation. 

Saliva—Its Functions and Importance. 

The saliva is secreted in the mouth to moisten 
the food. Its secretion is stimulated not only 
by the presence of food in the mouth but by 
the taste of the food. This taste is naturally 
more acute when the food is broken up into 
minute particles. Very small particles are 
easily dissolved and they more readily reach 
and affect the taste buds of the tongue. The 
muscular action of mastication itself also stim¬ 
ulates a secretion of saliva. A considerable 
degree of starch digestion takes place before 
this class of food leaves the mouth, providing 
it is masticated sufficiently to allow the saliva 
to penetrate it thoroughly. This is an impor¬ 
tant part of the digestion, since starch under¬ 
goes little further change until it passes out 



Constipation 


of the stomach into the intestines. Saliva is 
alkaline, which favors starch digestion, while 
the gastric secretion is acid—a chemical inter¬ 
ference to starch digestion. There is, how¬ 
ever, a continuation of this digestion to some 
extent in the stomach if the saliva has been 
thoroughly mixed with the food. But as soon 
as gastric acidity has increased to a certain 
point, the starches then lay in the stomach in 
the acid medium, which tends to produce starch 
fermentation, until the starches pass into the 
first part of the intestine. Since mastication 
helps the stomach to do its share of digestion 
more rapidly, the food will more quickly pass 
out of this organ if it has been properly pre¬ 
pared in the mouth, and therefore fermenta¬ 
tion is much less liable to result. As fer¬ 
mentation is one cause of constipation, it will 
be seen how important is this simple voluntary 
first part of digestion. 

The food is passed from the mouth into the 
pharynx and thence into the esophagus ; this 
is a tube eight inches or more in length (in the 
adult), continuous with the cardiac orifice of 
the stomach, which is located slightly to the 
left of the center of the body immediately 
below and back of the angle of the lower ribs. 

4 




A—pharynx; B—esophagus; C—stomach; D— 
small intestines; E—beginning of large intestine, 
the large pouch below being the cecum; F— 
ascending colon; G—transverse colon; H—de¬ 
scending colon; I—sigmoid flexure; J—rectum 
and anal orifice; K—appendix. 


5 














Constipation 


The Stomach and Its Functions. In the 

stomach a large part of protein digestion is 
carried on. As already stated, when the food 
is thoroughly masticated by the teeth the work 
of the stomach is much facilitated; the diges¬ 
tive juices of the stomach work their way into 
all particles of the food and the necessary 
chemical digestive action is started at once. 
But whether or not this mastication is com¬ 
pleted, the circular and longitudinal muscles 
of the stomach, by rhythmic and alternate 
contraction, produce a churning effect which 
moves all of the contents of the stomach back¬ 
ward and forward, or, rather, from one end of 
the stomach to the other, and back again. This 
helps to mix the food and the digestive juices 
thoroughly. 

During this time the gastric juice is being 
continually secreted, and as it is of an acid 
nature, the entire contents of the stomach 
gradually become acid in reaction. When the 
chemical action has been carried on completely 
enough that the acidity of the whole mass is 
sufficiently high, this acidity stimulates the 
outlet of the stomach (the pylorus ), which 
orifice opens and allows a small portion of the 
food to escape into the duodenum or first part 
6 



The Alimentary Canal 


of the small intestine. The acidity then pres¬ 
ent in the duodenum, or the decreased alka¬ 
linity in the stomach, causes a closing of the 
pylorus, which remains closed until the 
stomach acidity has again reached a degree 
high enough to stimulate it to reopen. This 
process continues until the stomach has been 
emptied of its food contents and of its own 
secretions that are mixed with the foods. Some 
of these secretions are later reabsorbed with 
the digested food products. 

Intestinal Digestion. As soon as the first 
of the food passes from the stomach into the 
duodenum it begins to undergo further change, 
brought about by the juices encountered in 
this section of the intestine. Here it comes in 
contact with intestinal juices, with bile, and 
with the secretion from the pancreas. The 
saliva contains a ferment that produces a 
chemical change only in the starches of the 
food; the stomach secretion contains hydro¬ 
chloric acid and ferments which act mainly 
upon proteins and to some extent upon the 
protein walls of the fat cells; but the secre¬ 
tions encountered in the intestines contain 
ferments or digestive agents (also called 
enzymes) which act upon all three main classes 



Constipation 


■of foods—starches, proteins, and fats—and 
carry them through all changes of digestion 
until this process is concluded and the food 
is ready for absorption and assimilation. 

The Small Intestines. The small intestine 
in the adult is about twenty feet in length. It 
is really one continuous tube but is arbitrarily 
divided, by anatomists, into three parts; the 
first part is about ten or eleven inches in 
length and is called the duodenum ; the name 
means “twelve finger breadths” and refers to 
its length. The second division is about eight 
feet in length and is called the jejunum\ this 
word means “hungry,” as this part of the in¬ 
testine is practically empty when the body is 
examined after death. The final portion is 
about twelve feet in length and is called the 
ileum ; this word means “twisted or kinked.” 

The small intestines are convoluted or 
turned or folded upon themselves so as to lie 
in a comparatively small space in the abdo¬ 
men. They do not join the large intestine 
end to end, but terminate at the side of the 
first portion of the large intestine at a point 
a few inches from its beginning, as shown in 
the illustration of the alimentary canal. The 
;small portion of the large intestine back of this 
8 



The Alimentary Canal 


point of junction is a closed or blind sack 
called the cecum. At its lower side is a small 
process called the vermiform appendix; this 
ranges from one-half inch to nine inches in 
length with an average of three to four inches, 
and its diameter varies from one-eighth to one- 
fourth of an inch. 

The Large Intestines. The large intestine 
is about five feet in length, its caliber being 
considerably larger than that of the small in¬ 
testine—decreasing from the cecum to the 
sigmoid flexure, where it dilates, and then is 
constricted again in the rectum. As with the 
small intestine, the large intestine also has 
three arbitrary divisions: the cecum (meaning 
“blind”), already mentioned; the colon 
(meaning “large intestine”), and the rectum 
(meaning “straight”). The cecum is in the 
right groin or lower right corner of the ab¬ 
domen and \s about two and one-half inches 
long and three inches across. From here the 
ascending colon extends upward to the under 
surface of the liver where it turns to the left 
and passes as the transverse colon across to 
the left side of the body at the inner surface 
of the spleen; here it turns downward and con¬ 
tinues as the descending colon to the left groin 



Constipation 


where it makes an inward and backward turn 
in the sigmoid flexure (meaning “S-shaped”), 
then continues on as the rectum and termi¬ 
nates in a guarded orifice, the anus. This ori¬ 
fice is held tightly closed at all times except 
when stimulation demands that it open to 
allow the passage out of collected refuse. This 
action of closing and opening is accomplished 
by circular bands of muscles, called sphincters, 
which are controlled by motor and sensory 
nerves. Normally the waste content rests in 
the sigmoid until there has been sufficient ac¬ 
cumulation for it to move into the rectum, 
which is normally empty. An accumulation 
of waste matter in the lower rectum produces 
a stimulation of the sensory nerves of the mu¬ 
cous membrane and, by a circuitous reflex 
action, the sphincter muscles relax, permitting 
the passage of the contents from the canal. 

Action In The Colon. It is highly neces¬ 
sary that as soon as the food is digested in the 
stomach it passes into the small intestines, 
and that as soon as it passes through the nec¬ 
essary digestive processes in the small in¬ 
testine it be conveyed into the large intestine. 
Here the greater portion of the liquid is ab¬ 
sorbed and the remaining portion becomes 
10 



The Alimentary Canal 


semi-solid. The inner surface of the colon is 
a series of semi-lunar (half-moon shaped) 
folds which retard the onward progress of the 
contents. This is a special arrangement to 
delay passage of the food along the intestines, 
thus assuring the absorption of sufficient 
nourishment from the solidifying contents. 
Were the inner surface smooth the contents 
would rush to the rectum, making their pre¬ 
mature evacuation necessary, and resulting in 
an extreme physical and economic loss. 

The Evacuation Process. The exact man¬ 
ner in which evacuations are possible and in 
which they take place is as follows: The liver, 
if normally active, sends bile into the intestines 
which mixes with, softens, and lubricates the 
contents; back of the contents the peristaltic 
contractions of the longitudinal muscular 
fibers of the intestines produce a shortening of 
the intestines and the circular fibers produce a 
narrowing of the lumen, both of which pro¬ 
gressively travel from above downward or to¬ 
ward the outlet, through the small and large 
intestines. At the same time there is a com¬ 
plete relaxation of the digestive canal below 
the mass of contents. In this way the contents 
are propelled gradually onward to the rectum, 
ll 




Constipation 


When at stool deep breaths are usually drawn 
and held for a few seconds; this depresses the 
diaphragm, forcing it deeper into the abdo¬ 
men, which in turn produces a downward 
pressure upon the intestines—mainly indirect¬ 
ly through the immediate pressure upon the 
liver, stomach and spleen; the external abdo¬ 
minal muscles contract and this action pro¬ 
duces an anterior and lateral pressure. These 
pressures, from the sides, front, and above, 
together with the nerve impulses from the 
rectal contents, cause the anal sphincters to 
relax and open, and thus the waste from the 
consumed food is cast from the body. 

Necessity for an Open Canal. But if any¬ 
where along the course from the stomach to 
the anus there is a deficiency of functional ac¬ 
tivity, involving musculature, nerves, mucous 
membrane or secretions, or a mechanical inter¬ 
ference with the churning and worm-like 
movements of the stomach or intestines, or a 
mechanical stoppage of the passageway, con¬ 
stipation will result and probably with its 
train of more or less serious symptoms. 

Evacuation a Normal General Stimulant. 
Few people are aware of the animating effect 
that should be secured by bowel evacuation. 

12 



The Alimentary Canal 


When the stools are mildly firm, well formed 
and cylindrical and of their natural diameter 
(which should be from one to one and a quar¬ 
ter inches), they naturally produce a fair de¬ 
gree of dilation of the sphincter muscles 
guarding the anal outlet. This is to a consid¬ 
erable extent a reflex relaxation, but even so 
there is a gentle dilation produced by the feces. 

Individuals prostrated from numerous con¬ 
ditions, some in apparently lifeless conditions 
or the coma preceding death, have been 
aroused and awakened and started again on 
the road to health by manual or mechanical di¬ 
lation of the anal sphincters. This effect is se¬ 
cured reflexly: the mild stimulation produced 
upon the sympathetic nerves of the sphincters 
travels upward to a ganglion at the extreme 
lower end of the sympathetic system of gang¬ 
lia; it then travels upward throughout the 
sympathetic system, reaching also the cere¬ 
brospinal system—the brain and spinal cord. 
The result of this is a general feeling of in¬ 
creased buoyancy and general well-being; one 
feels “lighter,” physical lassitude is reduced 
or overcome, and the general spirits rise: one 
is truly re-awakened and feels physically and 
mentally fit. 


13 



Constipation 


But this effect cannot be produced except 
when the bowel evacuations are normal in size 
and consistency. When they are extremely 
large and knotty they produce too great a 
stimulation and are inclined to make one more 
or less irritable. When they are soft they pro¬ 
duce no dilation of the sphincters, conse¬ 
quently one does not secure the stimulation 
that is normal. 

For these reasons efforts should be made not 
only to have the canal open freely but to have 
the stools normal in consistency. B owels too loose 
are preferable in many ways to constipated 
bowels. But for an arousing of the entire func¬ 
tions by a normally stimulated sympathetic 
nervous system it is essential that the stools be 
kept at a “happy medium” in consistency. 

Massage to the Prostate. It may have 
been especially designed by Nature that the 
prostate gland be situated in immediate con¬ 
tact with the rectum, that a gentle stimulating 
massage of this gland might be given regularly 
during bowel evacuations. At any rate this 
is the effect secured when the stools are of 
normal size and consistency. It is well known 
that a gentle massage of this organ has a mild 
sex-invigorating effect, providing the gland is 

14 



The Alimentary Canal 


not inflamed. When the stools are well- 
formed and cylindrical, once or twice daily as 
the case may be, this well-formed fecal plug 
is passed over the prostate and gives it a much 
more natural and less irritating massage than 
can possibly be given by any other means. In 
constipation the stools are retained unduly 
long and give an irritating pressure to the 
prostate; and when they are passed they are 
usually hard and give too deep massage, which 
is irritating rather than soothing or normally 
tonic in effect. It is well to say here also that 
when the stools are soft there is no massage 
given to the gland and the individual loses the 
invigoration he should receive. 

Some may secure the impression from this 
that frequent bowel evacuations will be bene¬ 
ficial, since by these either sex may secure the 
more frequent general stimulating effect of 
sphincter dilation, and the male sex will re¬ 
ceive more frequent invigoration through 
prostate massage. I wish to say here that any 
function increased beyond normal will prove 
harmful directly or later by exhaustion of 
function. Any attempt to bring about more 
frequent bowel evacuations than normal for 
the individual will result either in soft, non- 


15 



Constipation 


stimulating stools, or in the harm of over¬ 
eating, with the danger of toxemia and over- 
stimulation; these conditions may then create 
pelvic congestions, with gradual enlargement 
of the prostate or with irritation or inflamma¬ 
tion of this gland as the next step. In addi¬ 
tion, toxemia and over-stimulation very fre¬ 
quently result in excitement of the sexual 
functions with the probability of sexual ex¬ 
cesses, with their long train of symptoms. 
And, of course, the over-eating either aggra¬ 
vates constipation or creates fecal plugs of 
unnatural size and firmness, with direct in¬ 
juries to the prostate resulting from their pas¬ 
sage or attempted passage, also their long 
retention. The benefits of prostatic massage 
by bowel passage can be secured only by a 
diet normal in amount and variety, with free¬ 
dom from constipation or the opposite tend¬ 
ency. 


16 



CHAPTER II 


The Nature of Constipation 
ONSTIPATION is frequently called 



costiveness, and means literally a stop¬ 
ping of the intestines. It may be defined as a 
sufficiently unnatural retention of the contents 
at some part of the alimentary canal that 
there is an absorption into the blood of more 
toxic substances than can be effectually neu¬ 
tralized by certain organs designed to change 
the toxins into harmless substances. Or, in 
other words, it is “a condition in which the 
evacuation from the bowels are of insufficient 
frequency and amount, more or less fecal mat¬ 
ter being retained in the intestines.” If there. 
is a movement daily but of such small amount 
that there is gradually an accumulation within 
the intestines it is called costiveness. In se¬ 
vere cases which result in the complete closing 
up of the bowels it is spoken of as obstipation. 
But to the layman there is little or no differ¬ 
entiation between these and other degrees of 
intestinal inactivity. They are all, and prop¬ 
erly so, considered as constipation. 

Normal Stools. There is no definite line 


17 


Constipation 


that can be drawn between constipation and 
health. There have been people in large num¬ 
bers who have remained in apparently average 
good health, who have had two or three stools 
daily for long periods of time. In fact, more 
than one daily stool is a good safety valve for 
some very hearty eaters if they cannot be in¬ 
duced to eat more moderately and rationally. 
But on a normal diet the bowels will not act 
so frequently and should not be forced to do 
so, as some people in ignorance attempt to do. 
There are others who have had a movement 
but once in forty-eight hours, or in longer 
periods of time, but with no apparent diminu¬ 
tion of health or strength. This, in many 
cases, is normal also, because if one’s diet is 
very limited or if the diet contains little waste 
and the digestion is so perfect that most of the 
food is digested and assimilated there will be 
little residue to expel, thus requiring expul¬ 
sion at rather infrequent intervals. But in 
general it may be said that where one’s diet is 
normal in quantity and quality there should be 
at least one good evacuation in * twenty-four 
hours. The normal stool under these circum¬ 
stances should be well formed, smooth and not 



The Nature of Constipation 


knotty, cylindrical and not spherical in form, 
from an inch to an inch and a quarter in dia¬ 
meter, and totaling from six to eight ounces in 
weight, and be of medium brown color. 

In the histories of chronic diseases we find 
that eighty percent of the chronic sufferers 
have or have had constipation. This may be 
found as a cause or as a symptom of the exist¬ 
ing disease, but it may be simply an associate 
symptom resulting from general weakness of 
the body. I believe there is no doubt that con¬ 
stipation may be the cause of numerous acute 
and chronic disorders, but the fact that it ex¬ 
ists does not indicate that it is a cause of any 
symptom. In fact, constipation itself may be 
merely a result of some other disorder. 

Types of Constipation. The colon is the 
receptacle for the waste that becomes feces, 
and it is here that the mass becomes solidified. 
Dry feces are rarely found in the first part of 
the colon—the cecum or blind pouch. One 
may find large tumor masses of feces, however, 
at either the hepatic or splenic flexure; or a 
doughy, sausage-like mass in the upper part 
of the abdomen, above the navel; or, in the left 
groin may be felt an irregular lumpy mass. 

19 



Constipation 


Intestinal stasis may manifest itself in a 
variety of ways. Many people disclaim a di¬ 
agnosis of constipation when they are having 
frequent desires and frequent stools. But in 
these cases there may be extremely small 
evacuations at each time, there being accumu¬ 
lations steadily increasing in the intestinal 
canal. In other cases there is practically no 
desire, the bowels being inactive and appa¬ 
rently “dead”; the stools are large, hard, 
knotty, and dry as if burned. Usually the 
dryer the feces the more straining is required 
for their expulsion. Again there may be the 
fairly normal desire but with feces so hard and 
the passage so difficult as to cause a flow of 
blood from the mucous membrane of the rec¬ 
tum or anus; there may be fissures in and sore¬ 
ness of the anus constantly. Again there may 
be very light-colored stools associated with 
other symptoms of torpid liver, including a 
grayish-white coated tongue. In other cases 
there is a fairly frequent though rather faint 
desire for evacuation, but the stools are ex¬ 
tremely small and ribbon-like and probably 
are passed only with great strain; in these cases 
the odor is usually extremely disagreeable. 



The Nature or Constipation 


Types of Stools. The stools themselves 
may be used not only as a valuable means to 
determine the condition of the digestive tract, 
but they may also be of help in arriving at the 
diagnosis of an abnormal condition of some as¬ 
sociate or neighboring organ. For instance: 

Flat stools usually indicate hemorrhoids, 
uterine fibroids, enlarged prostate, or pro¬ 
lapsed, retroflexed or retroverted uterus. 

Pipe-like stools usually indicate prolapsus 
of the anus, or they may indicate starvation, 
pressure of hard dry feces, or spasm of the 
colon. 

Scybala (dry, hard, round feces) frequently 
indicate diabetes, but may indicate a severe 
case of intestinal atony with retention of feces, 
or ulcer of the stomach. They are frequently 
present with drug addicts. 

Pale or putty-like stools, under the ordinary 
diet, usually indicate jaundice, especially ob¬ 
structive jaundice. But they may also indi¬ 
cate long retention of feces, though usually 
this condition results in darkening of the color. 
The milk diet or a milk and vegetable diet may 
also produce the pale feces. 

Slate-colored stools result when iron, bis- 


21 



Constipation 


muth, charcoal and manganese are taken in¬ 
ternally, and are present in constipation more 
frequently than when the stools are normal. 

Offensive stools usually indicate retained 
feces, undigested food, fermentative processes, 
large consumption of meat with putrefaction, 
or jaundice, or rickets; they are also present 
when certain odorous foods such as onions and 
garlic have been consumed. 

Tarry stools usually result from decom¬ 
posed blood in the intestinal canal, and fre¬ 
quently indicate cancer of the stomach, duo¬ 
denum, or intestines; also ulcer of the esopha¬ 
gus, stomach, duodenum or intestines; cancer 
of the liver, bleeder’s disease (hemophilia), or 
leukemia. When one is placed on the Salis¬ 
bury meat diet he may have a very dark stool. 
Blackberries, huckleberries, black cherries and 
red wine also darken the stool. 

Bright blood in stools occasionally results 
from injuries in the lower intestines by consti¬ 
pation, though rectal ulcer or cancer or in¬ 
ternal hemorrhoids may result in the same. 

Concretions may be scybala of stone-like 
hardness—masses of feces from which all 
moisture has been absorbed; or they may be 
22 



The Nature of Constipation 


gall stones or pancreatic stones; large doses 
of olive oil also produce stones of fatty acid; 
(it is the passing of these stones, in cases of 
true gall stones where the olive oil treatment 
has been employed, that has led largely to the 
belief that olive oil is an effective remedy for 
gall stones). 

Sand in stools sometimes results from mu¬ 
cous colitis; also cancer of the colon. It is said 
that a feast of bananas will produce it, in ap¬ 
pearance, also a large number of figs. 

All of these varieties of stools may appear in 
constipation. It will be seen that some may 
be the cause of the constipation, while some 
will be produced by it; in others the condition 
that is responsible for them will likewise be re¬ 
sponsible for the constipation, and still others 
appear entirely independent of constipation. 


ACUTE CONSTIPATION 

Constipation may be either acute or 
chronic. I am applying the term “acute con¬ 
stipation” to that form that appears rather 
suddenly, is usually of short duration, and 
23 



Constipation 


fairly easily responds to slight and simple 
natural remedies. 

There are forms of acute constipation, how¬ 
ever, that result from pathological changes 
that finally reach a degree where they interfere 
with the opening through some part of the 
canal, with functioning of the nerves, nerve 
centers, or muscles of peristalsis, with the se¬ 
cretion of bile or its passage into the intestine, 
or with the action of the diaphragm or ex¬ 
ternal abdominal muscles, or from reflex ac¬ 
tion, or a combination of these causes. The 
symptoms and general conditions resulting 
from, associated with, or causing such acute 
intestinal stasis are usually of such grave or 
serious nature as to demand urgent and ex¬ 
pert care by a physician or, possibly, a sur¬ 
geon. 

In the other and usual forms of acute con¬ 
stipation the trouble usually lies within the 
rectum or lower colon, and there will probably 
be no tendency toward abnormal action of the 
digestive apparatus above the point of block¬ 
ing, as is apt to result from chronic constipa¬ 
tion. 

Marked emotions, especially those of a de- 

24 



The Nature of Constipation 


pressing nature, a change of food or water, a 
train or motor trip, or a period of enforced 
idleness for an otherwise active individual, as 
well as numerous other causes will bring about 
acute constipation in some individuals at cer¬ 
tain times. 

In the average person the acute condition 
will result in only slight inconvenience or per¬ 
haps in no symptoms at all. In very suscep¬ 
tible individuals, those of lazy habits, those 
who eat excessively of unwholesome foods, 
and the generally obese, there may be many of 
the general symptoms to be mentioned later 
under Symptoms of Constipation, Chap¬ 
ter IV. 

There is this peculiarity about the human 
body: it tends to become more or less immune 
to general disturbances from slighter disor¬ 
ders, especially when these disorders are con¬ 
tinued over a considerable period of time. This 
accounts for the almost complete lack of symp¬ 
toms in some people who have fairly severe 
acute or, in some cases, even severe protracted 
cases of constipation. Other individuals who 
are rarely constipated may, during the dura¬ 
tion of the severe attacks, experience general 
25 



Constipation 


symptoms of a more or less exciting or serious 
character. This is largely because their sys¬ 
tems have not undergone a “period of immu¬ 
nization,” and the toxins when absorbed 
through the mucous membrane of the intes¬ 
tines have full effect upon their bodies. The 
effects also depend to a considerable extent 
upon the nature of the toxins produced (which 
Is governed largely by the kinds of foods 
consumed), and upon the general suscepti¬ 
bility of the individual to symptoms from any 
abnormal condition. If an individual’s diet is 
what it should be, no harm will result and 
there will be no occasion for worry when there 
is an occasional skipping of a day’s evacua¬ 
tion. The more toxic the diet and the more 
defective the elimination through other chan¬ 
nels, the more necessary are regular bowel 
evacuations, and the more marked will be the 
symptoms from even an acute or brief con¬ 
stipation. 

If an acute case is not relieved within a 
short time by removal of the cause it may lead 
to a chronic form of the disorder. For this 
reason acute cases should be corrected within 
as short a time as possible, and by natural 
26 



The Nature of Constipation 


means; for if drugs are used then usually 
begins a chronic condition. 

CHRONIC CONSTIPATION 

Chronic constipation is the form with which 
we have most to deal. Acute cases are a fre¬ 
quent source of chronic intestinal stasis, main¬ 
ly for the reason that, usually, everything is 
done to remedy the trouble except what 
should be done—removal of the cause. Drug 
laxatives, taken so trustingly and innocently 
by thousands for the correction of acute bowel 
sluggishness, are one of the most productive 
sources of our chronic cases of constipation. 
However, there are many who find themselves 
victims of more or less severe chronic consti¬ 
pation before they are aware of the condition, 
since in many instances the trouble begins so 
insidiously and increases so gradually that it 
does not arouse one’s suspicions until after it 
has become deep-seated. 

To the average person constipation is mere¬ 
ly constipation—the same condition with all. 
So far as bowel evacuations are concerned this 
may be largely true, but a study of the causes, 
27 



Constipation 


symptoms and effects will clearly show that 
there is much variety in types and manifesta¬ 
tions. 

Besides the usual forms which will be more 
definitely described in the following chapter, 
there is the constipation of the aged, which 
differs somewhat from that kind of constipa¬ 
tion that appears before senility, as to cause 
and chances of remedying. This senile consti¬ 
pation is the result of a general reduction of 
hardiness and the inactive lives of this class of 
individuals. Their external and internal mus¬ 
cular tone is materially reduced and their di¬ 
gestive secretions are below normal not only 
in quantity but also in quality. Much depends 
upon the inherent vitality of such patients, the 
degree of general senility, the presence or 
absence of marked pathological changes, and 
the duration of the constipation, as to what 
results may be secured by any method of 
treatment. 

Then there is the constipation of infancy 
and childhood, which likewise has its own 
special features. But, as with all other ab¬ 
normal functioning and symptoms resulting 
therefrom in the early years, the response to 
28 



The Nature oe Constipation 


proper treatment is usually very prompt. Few 
factors of treatment are necessary and these 
do not require application in their more 
rigid forms. The average parents consult a 
family physician as soon as constipation or 
any other digestive disorders develop in their 
children and begin at once to give the pre¬ 
scribed laxative; or they visit the drug store 
and stock up with a supply of patent chil¬ 
dren’s remedies—perhaps the kind that “chil¬ 
dren cry for,” or are supposed to; possibly 
they have their own home remedies, herb teas, 
etc. In any case they fail to approach the 
cause, but they do not fail to begin the estab¬ 
lishment of more or less chronic and severe 
constipation as well as other digestive disturb¬ 
ances, starting the tiny infant or small child 
on a long train of abnormal conditions from 
which it may never be free—and from which 
it will never be free unless some radical change 
is made in the care or in the whole mode of 
living in later years. 


29 



CHAPTER III 


Causes of Constipation 

SPHERE are a thousand and one causes of 
^ constipation, practically all of them being 
preventable or correctable. A considerable 
variety of these will be enumerated here, and 
then I shall give a summary to show how 
closely related the various causes may be. 
Many of the minor ones tend to produce the 
few main causes that will require considera¬ 
tion when it comes to treatment of the dis¬ 
order. In many cases it is necessary to ob¬ 
serve many of the little causes, any single one 
of which would have slight effect upon an 
otherwise properly cared-for body but which, 
when several of them are taken together, 
create the intestinal disturbance. 

GENERAL CAUSES 

Heredity. It is claimed that in certain in¬ 
dividuals there is apparently a constitutional 
basis for the trouble. In some cases the re- 


30 


Causes of Constipation 


duced activity of the bowels seems to be a 
family complaint passed down from genera¬ 
tion to generation. In other words, the indi¬ 
vidual^ peculiarity or tendency to sluggish¬ 
ness is thought to be hereditary. But this 
“hereditary tendency” is most likely nothing 
but a continuation from generation to genera¬ 
tion of the same dietetic and hygienic errors. 
This is the explanation of many so-called 
“hereditary” diseases and susceptibilities. 
Constipation is more frequently present in 
brunettes than those of fair complexion, and 
complexion is hereditary; but it cannot be said 
that dark complexioned people directly in¬ 
herit constipation. There are certain peculi¬ 
arities of secretions in brunettes which cause 
them to respond more unfavorably to certain 
dietetic errors, and this accounts for the more 
frequent development of intestinal and certain 
other digestive disorders, including constipa¬ 
tion. Practically all of these cases of consti¬ 
pation can be corrected or controlled by diet 
alone. 

Environment. One’s environment doubt¬ 
less has much to do with the state of bowel 
elimination, when we consider that environ- 


31 



Constipation 


ment encompasses all external physical factors 
which may affect an individual in any way and 
to any degree. Surroundings have a very 
marked influence upon one’s mental processes 
and upon his equanimity, as well as upon his 
physical body. Usually one becomes so 
adapted to his environment that his system 
functions comparatively normally, even when 
this environment is such that it might be ex¬ 
pected to have an adverse influence. A change 
of environment, not necessarily from good to 
bad, may be a cause of sluggishness of bowel 
eliminations. This change may alter in no 
degree the general physical activity but may 
involve only a change in climate or soil, es¬ 
pecially when the change is to a chalky soil, 
or probably in drinking water. Most lands¬ 
men become constipated when taking a sea 
voyage. Usually constipation resulting from 
change of environment is transient, especially 
in those who have been previously free from 
bowel irregularities. 


DIET 

As eighty percent of all cases of constipa- 

32 



Causes of Constipation 


tion can be corrected by diet alone it must 
appear that this high percentage of cases 
results from improper foods or eating habits. 
There are many dietetic causes of constipa¬ 
tion; and dietetic errors that would cause this 
condition in one individual may not do so in 
another. Hence the personal equation or in¬ 
dividual characteristics and idiosyncrasies 
must be taken into consideration. In some 
cases there will be from one to several gross 
errors, in others several minor errors, while 
some people seem to err in every respect so far 
as their foods are concerned. The degree of 
constipation and the effects resulting from 
it may bear apparently no relation to the 
grossness or multiplicity of errors of diet. It 
all seems to be largely a question of individuals 
and what might be called their immunity or 
their special susceptibility. 

People undoubtedly vary considerably in 
their food requirements, and it is necessary to 
take into consideration the age, sex, tempera¬ 
ment, race, personal habits and occupation, as 
well as the climate and season of the year, be¬ 
fore it can be determined what would be a 
“balanced diet” for any particular individual. 


33 



Constipation 


There can be no question, however, that a diet 
that does not contain proteins, carbohydrates 
and fats, as well as the mineral elements and 
the “accessory food substances” (the vitamins) 
in sufficient amounts for the particular indi¬ 
vidual will provide inadequate nourishment for 
some certain function or functions of the body, 
and some of these will suffer in consequence. 
Usually a diet containing inadequacy of any 
certain element has an excess of some other 
element, thus causing an extra amount of work 
to be done by some organ or organs. In other 
words, the diet must be well-balanced for each 
individual, and all the factors mentioned above 
must be taken into consideration. But as I 
have stated, there are many dietetic errors that 
may be responsible for bowel inactivity, and 
these will be presented in greater detail below. 

Indigestible Foods. It is difficult to group 
any particular class of food articles together 
and call them indigestible, because here again 
the personal equation enters into the problem. 
An article of food that may be digested with 
perfect ease by one individual may cause even 
violent acute indigestion in another; again, an 
article that may digest normally when used 
34 



Causes of Constipation 


alone or in certain combinations may cause di¬ 
gestive disturbances when included in certain 
other combinations. 

Any food which does not digest in the nor¬ 
mal time and manner, that does not yield the 
usual amount of both food elements and waste, 
and that causes any degree of disturbance of 
digestive or other functions, may be consid¬ 
ered indigestible—for the individual in whom 
it produces these effects. Usually the consti¬ 
pating tendencies of such foods are the result 
of an undue amount of residual matter, which 
inflates the intestines, injures the mucous 
membrane and interferes with the normal se¬ 
cretions of the digestive canal. 

Devitalized Foods. Devitalized foods and 
demineralized foods are without doubt one of 
the most pronounced causes of constipation. 
The processes involved in “refining” and pre¬ 
paring foods for modern markets and for con¬ 
sumption result in the removal not only of 
vital nourishing elements but of elements 
which should be retained in order to maintain 
the normal chemical processes of body fluids 
and of the cells—especially the vitamins. 
These prepared foods form adhesive masses 
35 



Constipation 


also, free from lubricating and stimulating 
qualities and literally and figuratively they 
“stick to the ribs.” The prepared flours and 
starches are among the most seriously altered 
and constipating foods, since all the stimulat¬ 
ing elements have been removed. This in¬ 
cludes our white flours, our so-called graham 
flour, macaroni, spaghetti and noodles, and 
necessarily includes all of the white flour 
products such as are used in the great mass of 
pastry. 

Young children especially are liable to the 
constipating effects of faulty foods. 

Vitamin Deficiency. The exact nature of 
vitamins is not definitely understood, hut ex¬ 
haustive studies and experiments by many in¬ 
vestigators disclose facts that prove their vital 
importance. These accessory food substances 
have been found to be absolutely necessary to 
the growth, health, and proper functioning of 
the body. One, called water-soluble vitamin, 
or Vitamin B, is of extreme importance to the 
body. When it is deficient the body fails to 
grow normally, as it controls to some extent 
body growth; but its deficiency also prevents 
normal absorption of food material from the 
36 



Causes of Constipation 


digestive canal, and this results in the enlarge¬ 
ment of the intestinal contents and sluggish¬ 
ness of peristalsis. 

Sugars and Starches in Excess. Our 
super-refined sugars, whether they be made 
from cane or beets, come in the class of devital¬ 
ized, demineralized foods. We are continually 
using increasing amounts of sugar and sugar 
products, and these are coming to be a more 
and more prolific cause of intestinal disturb¬ 
ances, including stasis. Sugar provides no 
stimulation whatsoever to intestinal muscular 
activity; it irritates the mucous membranes 
and produces catarrhal inflammations; and it 
robs the blood of nourishing elements, since it 
is absorbed quickly and keeps the blood in a 
state of saturation, thus preventing it from 
absorbing genuinely beneficial elements. Un¬ 
refined sugars provide a certain amount of 
nourishment in addition to flavor and sweet¬ 
ening, but used in more than the smallest 
amounts even these are injurious enough. The 
constipating effect of an over-abundance of 
these foods is produced in still another way— 
by their drawing so much of the intestinal fluid 
to them for their solution and absorption that 
37 



Constipation 


the bowel contents are deprived of sufficient 
moisture to keep them soft and pliable. 

Sugar and Starch Deficiency. The diet of 
the average person is not apt to be lacking in 
these foods, but those who eat excessively of 
meat and fats are sometimes “fed up” on these 
to such an extent that they do not care for 
other foods. We have seen that the pancreas 
in its secretion supplies a ferment for the di¬ 
gestion of each primary food element or class 
of food. But it will not supply its secretion 
or at least the ferment for any particular class 
of food if this food is not taken into the body, 
as the body is always working in an economical 
way. If starches and natural sugars are not 
made a part of the diet, or if they are con¬ 
sumed in insufficient amounts the ferment for 
this food will not be secreted. Thus the entire 
secretion of the pancreas will in time be re¬ 
duced in amount and effectiveness. As this 
secretion is necessary to aid in the formation 
of fatty acid and glycerin, which help to keep 
the bowel contents soft and peristalsis active, 
the feces become hard and peristalsis difficult. 

Deficiency of Fats. In a like manner a 
diet that is lacking in fats or oils will reduce 
38 



Causes of Constipation 


the pancreatic activity, or if the secretion is 
passed into the canal there will be nothing for 
the production of the glycerin and soap— 
which, as has been stated, are necessary for 
normal peristalsis and consistency of bowel 
contents. Diarrhea may be the initial abnor¬ 
mal condition of the bowels, but obstinate con¬ 
stipation will soon take its place. An excess 
of fats and oils will in time produce constipa¬ 
tion because of the indigestion resulting, or 
from the reaction following the diarrhea which 
first appears. 

Over-eating. It is a fact that cannot be 
refuted that over-eating is one of our most 
prominent causes of constipation. Before the 
age of thirty-five or forty is the time of life 
when this injustice is committed against the 
body to a greater and more serious extent. 
There is sad truth in the statement that thou¬ 
sands of people “dig their graves with their 
teeth”. While I can conceive of absolutely 
no place in the human economy nor in our 
social system for alcohol in any form, I am 
convinced that some of the most vehement an¬ 
tagonists of alcohol, as well as countless thou¬ 
sands of others, are constantly intoxicated 
39 



Constipation 


through their intemperate eating habits. I be¬ 
lieve also that intemperate eating has produced 
and will continue to produce more universal 
and widespread physical disabilities than al¬ 
cohol ever has produced or ever will produce. 

Excessive foods produce excessive wastes, 
and disturb digestive functions, with au¬ 
totoxemia as a result—from accumulation of 
both wastes and undigested foods. The indi¬ 
gestion, putrefaction, fermentation and reten¬ 
tion stretch the colon walls and decrease in¬ 
testinal muscular tone, which further increases 
inactivity, this allowing still greater collection 
of waste in the digestive tube. Thus is estab¬ 
lished and maintained a vicious circle. 

Under-eating. It may seem, from what has 
just been said concerning the tendency to 
over-eat, that we would find few cases where 
an insufficient amount of food was the cause 
of bowel inactivity, and it is true that this is 
not especially common. However, there are 
some people who use an excess of the pre¬ 
digested foods, which are too completely ab¬ 
sorbed and which provide practically no resi¬ 
due, and this lack of residual material causes 
directly an intestinal sluggishness. A lack of 
40 




Causes of Constipation 


normal stimulation and of the exercise of per¬ 
istalsis will result in loss of muscle tone as 
certainly as will over-stimulation and over¬ 
distention, though the effect will be less diffi¬ 
cult to correct. Those who have passed mid¬ 
dle life, especially those who have entered the 
period of physical decline, are usually the peo¬ 
ple who resort to “light” foods and to those 
which furnish inadequate bulk. 

Protein Excess. The average diet con¬ 
sists of an excess of protein foods which, be¬ 
cause of wrong combinations, undergo pu¬ 
trefaction with resulting irritation to intesti¬ 
nal mucous membrane. Not only this, but 
the over-use of proteins is bound to result in 
indigestion and this will further delay the pas¬ 
sage of the bowel contents; putrefaction and 
its attendant fermentation will produce gas, 
with its dilation of the intestinal walls, espe¬ 
cially the colon; impairment of the contrac¬ 
tility of the bowel muscles will result from 
this, and stagnation will be the final direct ef¬ 
fect. Protein is deficiently stimulating to the 
peristaltic action, and when taken in excess, 
especially with the conventional diet, it must 
41 



Constipation 


necessarily create or aggravate sluggishness 
throughout the alimentary canal. 

Protein Deficiency. Usually one will have 
little trouble from constipation when his diet 
contains a deficiency of protein; but such a 
diet will in time produce general malnutri¬ 
tion, which will lower the tone of all tissues, 
including the bowel muscles. This, of course, 
would result in a lethargic condition of the 
intestinal canal. However, as there is so little 
likelihood of one securing a lack of this ele¬ 
ment, and as the dangers of an excess are so 
much more to be feared, one may well give 
little or no consideration to this cause of con¬ 
stipation. 

Deficiency of Cellulose or Roughage. 

The start of a large number of cases of con¬ 
stipation is food containing a deficiency of 
bulk or residue. The waste from the average 
diet does not produce sufficient stimulation to 
bring about natural intestinal activity, as this 
diet is markedly deficient in green vegetables 
which supply indigestible cellulose, in fresh 
fruits which have chemical elements and resi¬ 
due especially effective as gentle stimulants 
42 



Causes of Constipation 


to intestinal peristalsis, and in the coarser por¬ 
tions of cereals. 

Excess of Roughage. The diet of many 
others contains a marked excess of coarse 
foods, with such quantities of residue that the 
nerves and mucous membranes of the intes¬ 
tines are ot;^r-stimulated, which in time results 
in a retardation of the intestinal functions. 
The use of a large amount of bran or other 
coarse cereals, or of a larger bulk of salad 
vegetables or of sweet laxative fruits than the 
system requires, will be very apt to result 
eventually in an aggravation of the consti¬ 
pation for which this excess food is sometimes 
taken as a “cure.” 

Fruit Deficiency. The average person uses 
practically no fruit with the possible excep¬ 
tion of a few months in the summer. It is 
during the colder months when the diet is 
heavy and mainly of starches and proteins, 
that fruits are required more than at any other 
time of the year; yet they are used in still 
smaller amounts if at all. Some people be¬ 
lieve that fruits thin the blood and that this 
effect is not to be desired when one must re¬ 
sist the cold. The fact is that blood circu- 


43 



Constipation 


lates more rapidly when it is less viscid and 
concentrated. In every respect fruits improve 
not only the quality and circulation of the 
blood but every function of the body, not the 
least of which is waste elimination. But an 
excess of fruit acids, or other astringent foods 
as vegetable acids and vinegar, may produce 
a constipation by their puckering, contracting 
effect upon the mucous membranes of the di¬ 
gestive tract, similar to but less than that pro¬ 
duced by tea. It might be said, however, that 
recent experiments would seem to prove that 
it is practically impossible to eat so many 
oranges as to produce a bad effect. 

Insufficient Mastication. With many other 
people the food itself may be well-balanced 
with respect to the elements, cellulose and di¬ 
gestible portions but it is not sufficiently mas¬ 
ticated. When this is the case, the food may 
produce sufficient irritation as to set up a ca¬ 
tarrhal inflammation or gastritis or dyspepsia; 
or it may result in consumption of a greater 
bulk than necessary, this further resulting in 
a dilation or prolapse of the stomach. It 
may also produce inflammatory changes 
throughout the length of the intestines. Over- 

44 



Causes of Constipation 


stimulation eventually results in reduced func¬ 
tioning of one or more portions of the intes¬ 
tinal canal, and constipation is produced. 
Coarse foods in large amounts, foods poorly 
masticated, drugs, alcohol, spices, condiments, 
pickled foods, smoked foods, and all other un¬ 
natural foods are some of the stimulating sub¬ 
stances taken into the intestinal tract which' 
may give rise te, constipation. 

Water Insufficiency. Water is a marked 
intestinal stimulant of which the average per¬ 
son consumes far too little. It is unneces¬ 
sary and possibly injurious to consume too 
large quantities, but it is more injurious to 
use less than the system requires. The tis¬ 
sues and cells of the body cannot function 
normally, they cannot absorb nourishment nor 
discard their waste, and they are not so re¬ 
sponsive to nerve stimuli, when they are de¬ 
nied through the blood a sufficient amount of 
diluting, dissolving water. All functions are 
reduced when the intake of water is low. But 
of greater direct effect, so far as bowel ac¬ 
tivity is concerned, is the fact that water helps 
maintain normally soft and plastic feces, 
45 



Constipation 


through the absorption of the fluid by the un¬ 
digested cellulose. 

Excessively Dry Foods. As a lack of suffi¬ 
cient water retards bowel activity by tending 
to create a dry and hard condition of bowel 
contents, so will a diet that is very dry tend 
to give similar effects. Women especially are 
inclined to use an insufficiency of water or 
other fluids, except tea and coffee, with their 
meals or at other times during the day. Other 
people use an excess of foods practically free 
from moisture, such as breads, dry cereal, 
toast, crackers, cheese, and over-cooked foods. 
These foods should be avoided or used in very 
small amounts where there is a tendency to 
bowel sluggishness; or considerable water or 
other wholesome fluid should be taken to sup¬ 
ply the moisture needed. 

Irregularity of Meal Hours. Irregularity 
of meal hours is a cause of constipation in 
some cases. Someone has called the regular¬ 
ity of body functions the “periodicity of func¬ 
tions”. As we have seen elsewhere, the body 
glands, organs, and tissues accustom them¬ 
selves to certain habits, and the organs and 
associate organs of digestion are in the habit 
46 



Causes of Constipation 


of supplying their secretions at stated hours. 
The nerve centers that control the various 
functions are also habituated to respond regu¬ 
larly to accustomed stimuli and are “keyed 
up” to respond to the anticipated incentive. 
When this is not forthcoming or when it is 
supplied prematurely the functions are either 
beyond their period of keenest response or this 
period has not yet arrived. Were we living 
strictly in accordance with Nature our diet 
would contain enough of necessary residue, 
we would have sufficient water, and we would 
exercise enough to keep our intestinal activity 
at normal, regardless of irregularity of meal 
times. But since the modern diet keeps the 
bowels either constipated or on the verge of 
constipation, when a meal is delayed a few 
hours or advanced a few hours the rhythmic 
movement of the intestines and colon are dis¬ 
turbed and constipation may follow. 

While I am convinced that one should eat 
only when hungry I am equally convinced 
that if one’s diet is kept reduced to the actual 
body requirements, in each individual there 
will be developed a sufficient natural hunger 
that regular meals will be eagerly received 
47 



Constipation 


and fully digested. This kind of diet will also 
tend to keep the intestinal tract normal so 
that if it is necessary to postpone a meal there 
will be no marked disturbance of any func¬ 
tion. But I can see no occasion for advanc¬ 
ing a meal ahead of the usual hour, except 
when a meal or meals before have been omit¬ 
ted or reduced below the usual amount. 

Tea-drinking. There is one cause of consti¬ 
pation that is rarely considered but which I 
believe to be rather frequent; this is the drink¬ 
ing of large amounts of tea. Tea contains 
tannin, which has a very pronounced astrin¬ 
gent action, and when it is used in large 
amounts or in fairly small amounts frequently 
and over a considerable period of time it will 
produce a permanent contraction of the mu¬ 
cous membrane of the intestines, interfering 
thereby with secretions, with circulation, and 
with nerve and peristaltic action. Coffee also 
has this effect on some people, though to a 
less marked extent. 

HABITS 

Ignorance. Ignorance is responsible for 

48 



Causes of Constipation 


the prevalence of constipation as well as of 
numerous other abnormal conditions. The 
average person gives his bowels little if any 
consideration, and if their action is retarded 
the most ignorant form of treatment is 
adopted. 

Drugs. Anyone who gives the least thought 
to the subject of digestion and of the process 
by which wastes are removed from the system 
cannot but realize that constipation corrected 
by drugs is constipation perpetuated. One 
of the most frequent causes of a chronic con¬ 
stipation resulting from an acute or very mild 
constipation is that coming from the abuse of 
cathartics or laxatives. Remedies for dyspep¬ 
sia and mild gastritis, and other conditions 
of the intestinal tract usually considered mild, 
also give rise to a similar condition because 
of the damage they do to the mucous mem¬ 
brane and secretory cells. 

Wherever there is constipation there is food¬ 
poisoning and this is not confined to the intes¬ 
tinal tract: it involves every cell of the body; 
and in order to correct this food-poisoning, as 
well as constipation, further treatment than 
drug stimulation of the intestines is absolutely 


49 



Constipation 


necessary. Even though the bowels may be 
forced by drugs to expel their contents, the 
food poisoning necessarily remains. 

Insufficient Exercise — Sedentariness. 
Lack of sufficient exercise is also the result 
of ignorance. The human machine is a mus¬ 
cular machine to a considerable extent, and 
all functions are increased when the muscles 
are kept in proper tone and decreased when 
muscle tone decreases. 

Sedentary habits, or at least activity which 
does not bring into contraction the abdom¬ 
inal muscles, is a fruitful source of constipa¬ 
tion. The people who are most affected by 
sedentary habits are those who eat too much 
and who neglect or postpone the calls of Na¬ 
ture. Those of the hothouse variety who en¬ 
joy luxury with no hardships, who have too 
much sleep on beds too soft, and who are con¬ 
fined in hot, poorly ventilated apartments 
without the tonic effect of fresh breezes and 
sunlight, are all subject to constipation; and 
they are prolific buyers of the ineffective so- 
called constipation remedies. The sedentary 
occupation of the average individual results in 
a soft, flabby condition of external muscles 


50 





The wrong sitting posture. Instead of sitting at edge of 
chair, bring thighs far back on chair seat so that the 
spine will follow more nearly the back of the chair; keep 
shoulders and head back, but without strain. With well 
trained muscles one assumes the proper position without 
spinal strain. 

51 





Constipation 


and no less so of the internal muscles, and in 
many cases the intestinal tract becomes slug¬ 
gish in direct ratio to the decreased tone and 
sluggishness of the external muscles. Stu¬ 
dents and others who change from a physi¬ 
cally active life to one of inactivity almost 
invariably have intestinal sluggishness. 

In these individuals of perpetual sedentary 
habits we have some of the most stubborn of 
all cases of intestinal stasis. In many of them 
the condition has existed for so long a time 
and has developed to such a degree that an 
actual obstruction of the bowels has resulted; 
and in many of them a weakness of the tissues 
and of the nerves and the pollution of the 
blood have become so marked that the restor¬ 
ation to a healthy condition is well nigh im¬ 
possible. 

While special exercises will be valuable in 
connection with general physical activity in 
the correction of constipation, no such special 
exercises would be necessary to prevent this 
trouble if the entire body were given sufficient 
muscular activity. 

False Modesty. False modesty is still a 
cause of constipation but not so much so as 


52 



Causes of Constipation 


formerly. However, there are yet too many 
people who are ignorant of the danger result¬ 
ing from suppression of evacuation-stimuli 
and whose sense of false modesty prevents 
them from excusing themselves from associa¬ 
tions to respond to Nature’s call. In these 
we find more or less pronounced constipation, 
frequently with a train of symptoms. Matur¬ 
ing girls are usually affected from this cause. 

Postponing — Laziness. Postponing, re¬ 
gardless of the reason, produces similar re¬ 
sults. Many times one is in some form of 
amusement or entertainment or occupation 
which he does not care to leave for the time 
being. Ignorance of the danger is responsible 
for the delay and the consequences. There 
have been numerous instances of where even 
a strong stimulus for evacuation has been con¬ 
trolled for some time—probably even for as 
short a time as fifteen or twenty minutes— 
following which a very large and dry fecal 
plug has formed far down in the rectum, mak¬ 
ing evacuation extremely difficult and some¬ 
times impossible without artificial aid; and, 
strange as it may seem, the desire for evacua¬ 
tion does not return for a long time after this 
53 




The usual slouching posture of the improperly trained 
body. The sunken chest and protruding abdomen prevent 
the abdominal organs from maintaining their normal posi¬ 
tions and functioning properly. The drooped shoulders 
constrict the chest, causing shallow breathing, weak lungs. 
Constipation is prevalent in those who hold this position. 


54 







The proper standing- position, also the correct position of 
trunk while sitting. There is no strain and yet the chest 
is held high, shoulders back, head up; the whole body 
inclines slightly forward, and there is ncn sagging of 
abdominal organs, from the posture itself. 


55 




Constipation 


disregard and suppression of the normal in¬ 
clinations, nor does it return with normal urg¬ 
ency. 

Laziness leads to the same failure to re¬ 
spond immediately to the stimulus to evacu¬ 
ate the bowels, and the consequences are the 
same as where the stimulus is willfully sup¬ 
pressed. 

Lack of Regular Time. Another extremely 
frequent cause of intestinal stasis is a lack of 
a stated daily time for emptying the bowels. 
As I have said elsewhere, many of the organs 
of the body are capable of forming habits, the 
intestines being among these; in fact they are 
more susceptible to habit formation than prac¬ 
tically any other organ of the body; and when 
the regular daily evacuation habit has not been 
developed they may retain their contents for 
a much longer period of time than where this 
habit is established. 

Modern Posture as a Cause. The natural 
position to assume during the act of defecation 
has been dispensed with because of the modern 
toilet seats. Even with the advent of out¬ 
houses this position changed from a natural, 
helpful one to an unnatural, negative position. 

56 



Causes of Constipation 


Before we resorted to toilet seats the position 
involved the low suspension of the pelvis with 
considerable pressure by the thighs upon the 
abdomen. The modern position raises the 
hips high and, though not necessarily so, usu¬ 
ally places the abdomen free from the thighs. 
This may he corrected in one of two ways: 
A block or stool may be placed immediately 
in front of the toilet seat, raising the thighs 
so as to approximate the normal position; or 
one may lean far forward so as to secure the 
abdominal pressure by the thighs. The for¬ 
mer position is the better remedy, but the lat¬ 
ter will be satisfactory, and calls for no extra 
equipment. 

Undue Straining. Many people have 
formed the habit of making considerable mus¬ 
cular effort to expel the bowel waste; they 
strain with all the power of the diaphragm 
and external abdominal and pelvic muscles. 
This is not only liable to produce hemorrhoids 
or prolapse of the rectum or anus, but is very 
apt to defeat its own purpose by causing an 
increased contraction of the sphincters. Light 
tension of the muscles mentioned is sometimes 
an aid and may be safely employed, but the 
57 



Constipation 


sphincters must be allowed to relax, or they 
fail to open. 


FUNCTIONAL, ORGANIC AND GENERAL 
CAUSES 



The internal layer of the abdominal 
muscular corset formed mainly by 
the transversalis muscle. 


The Mus¬ 
cular Corset. 

As we have 
heretofore 
seen, in Chap¬ 
ter I, after 
food has been 
passed from 
the stomach 
into the in¬ 
testines it is 
gradually 
forced along 
by the wonn- 
like motion of 
this digestive 
tube. This 
action is pro¬ 
duced by cir- 
cular and 
longitudinal 


58 




Causes of Constipation 


muscles belonging to the sympathetic (auto¬ 
nomic, vegetative, or involuntary) nervous sys¬ 
tem, the normal intestine having a more or less 
constant worm-like or peristaltic movement 
whether containing food or empty. When 
empty the movements are naturally slighter, 
because the stimulation is slight. For normal 
activity it is necessary that the intestines be 
stimulated only sufficiently for them to carry 
on their work with the amount of food they 
contain. But, naturally, they must be stimu¬ 
lated to the required degree and be capable of 
responding to the stimulation. Where they 
are over-stimulated by any cause (some of the 
causes previously mentioned), there will re¬ 
sult in time the condition that follows all over- 
stimulation—a reduction of activity through 
enervation, exhaustion, or partial paralysis of 
the nerves. 

Enervation and Muscular Atony. When 

the nerve supply of any muscle is lessened 
from any cause the muscle itself is weakened, 
but in many cases there are other factors at 
work to produce weakness of the muscles of 
the intestines, even when the nerves are nor¬ 
mal in action. These other factors are any 


59 



Constipation 



influences 
which pro¬ 
duce a relaxa¬ 
tion or dila¬ 
tion of the in¬ 
testines, espe¬ 
cially of the 
colon. Food 
in excess, 
foods which 
ferment and 
produce a 
large amount 
of gas, reten¬ 
tion of food, 
o r frequent 
injection o f 
large amounts 
of water will 
so dilate the 
intestines and 
stretch and weaken the muscles that the 
minute blood vessels contained within the 
muscles and mucous membranes will be obliter¬ 
ated or squeezed so that they cannot feed the 
muscles and tissues properly. This produces 


The middle layer of muscle forming 
the natural abdominal corset—the 
internal oblique. 



Causes of Constipation 


atony of the muscles, and the lack of nourish¬ 
ment will in time result in a deadening of the 
nerve endings themselves so that even fairly 
complete functional paralysis will eventually 
result. 

This effect upon the nerve endings may 
pass backward over the nerves until the spinal 
cord itself, at the point where these nerves 
originate, is greatly reduced in vitality and 
ability to transmit normal impulses. In many 
cases these areas of the spinal cord are so af¬ 
fected that all cells here are weakened, which 
condition then results in feeble impulses or a 
total lack of impulses to the superficial or ex¬ 
ternal voluntary muscles of the abdomen, as 
well as to the involuntary muscles of the intes¬ 
tines. This results in a weakened, flabby mus¬ 
cular corset, which prevents proper support 
of the abdominal organs and voluntary pres¬ 
sure and impetus by these muscles to the in¬ 
testines during the act of defecation. 

Thus, from the causes which tend to destroy 
the elasticity of the colon itself, may come a 
whole train of conditions, any one of which is 
sufficient to cause and perpetuate constipa¬ 
tion ; and when constipation is once established 
61 



Constipation 


it directly and reflexly affects the entire ali¬ 
mentary canal, disturbing the muscular action 
and modifying or reducing the digestive se¬ 
cretions. These altered conditions themselves 
then perpetuate and aggravate the constipa- 

tio n and a 
constant vi¬ 
cious circle is 
e st a blished 
and main¬ 
tained there¬ 
after. 

Obesity, 
Other fre¬ 
quent causes 
o f weakness 
of the volun¬ 
tary or exter¬ 
nal abdominal 
muscles are 
numerous. 
One of these 
is the accum¬ 
ulation of a 

The external muscle of the abdom- lnrcrp nrnrmnf 
inal corset—the external oblique. am0unt 

This also shows the other muscles of fat in the 
and the markings immediately be- i j 
low the skin of the abdomen. abdominal 

62 








Causbs of Constipation 


walls; this draws the abdomen downward and 
outward by the sheer weight of the excess tis¬ 
sues. In these eases there is frequently or 
perhaps usually the added weight of a consid¬ 
erable amount of fat within the abdominal 
cavity, especially on the omentum, which sus¬ 
pends like an apron down from the anterior 
surface of the stomach to the lower part of 
the abdomen and then swings upward to at¬ 
tach to the under and posterior surface of the 
transverse colon, then upward and backward 
to the posterior surface of the abdominal 
cavity. When this is weighted with fat it helps 
to force the abdomen outward as well as the 
stomach and colon downward. 

Frequent Pregnancies. Frequent pregnan¬ 
cies also dilate the abdomen and stretch and 
weaken the abdominal muscles as they become 
thinner. The thinner they become the more 
poorly nourished they become, and this fur¬ 
ther weakens them and makes them liable to 
still greater relaxation and prolapse. This 
dilating effect can be overcome to a consider¬ 
able extent, however, if the woman will exer¬ 
cise regularly between pregnancies and will 
take the proper exercises during pregnancy. 

63 



Constipation 


Strains and Injuries. Weak abdominal 
walls may be made to protrude and give less 
than the normal support by lifting and strain¬ 
ing or by any means which increases intra¬ 
abdominal pressure. Protracted coughing 
from colds or other conditions may be one 
cause. Whatever the cause, when the mus¬ 
cular corset loses its ability to hold the abdo¬ 
minal structures in normal position in relation 
to each other, the organic activity will be re¬ 
duced and intestinal sluggishness invariably 
will be the ultimate consequence. 

REDUCED FUNCTIONING 
(HYPOFUNCTIONING) 

Another set of causes of constipation is any 
disease of the digestive tract itself which re¬ 
sults in reduction of the functioning processes. 

In the Stomach. Stomach activity may be 
reduced as a result of dyspepsia, ulcer, cancer, 
etc. While in some of these the secretions 
may be increased in amount, or the motor ac¬ 
tivity accelerated, these changes are tempo¬ 
rary and spasmodic only, and all processes are 
eventually defective. A reduction in amount 


64 



Causes of Constipation 


or quality of the hydrochloric acid or an ab¬ 
sence of this secretion materially lessens stom¬ 
ach digestion and produces or aggravates con¬ 
stipation. This is a frequent result of 
gastric catarrh. There may be a dilation of 
the stomach called, technically, gastrectasia, 
or a more or less marked prolapse of the stom¬ 
ach without weakness of the abdominal corset. 
In some very thin individuals, also in some fat 
individuals, the stomach may he so greatly 
prolapsed that its greater curvature will rest 
within the pelvis. In these cases of dilation 
or prolapse the functional processes are nat¬ 
urally greatly retarded; digestion is delayed 
and the passage of the food into the intestinal 
tract is materially retarded, with constipation 
following as a natural consequence. 

In the Intestines—Reduction or Altering 
of Intestinal Secretions. Any factor which 
reduces the amount or quality of the secre¬ 
tions will naturally delay the passage of the 
contents of the intestines and colon. 

Catarrhal Inflammations. Inflammations 
are the most frequent cause, and catarrh is 
the most frequent form of inflammation. Usu¬ 
ally in case of catarrh of the stomach there 
65 



Constipation 


will be catarrh of the intestines. Catarrh of 
the intestines, especially, may result in con¬ 
stipation because of the interference with se¬ 
cretion by intestinal glands and mucous mem¬ 
branes and with muscular activity. But con¬ 
stipation may likewise result in the catarrhal 
condition, from the accumulation of toxic ma¬ 
terials and the direct irritation to the intes¬ 
tinal lining. In fact, as will be seen later, 
constipation may be practically the first 
abnormal function of the body, but may re¬ 
sult in one or more extremely serious abnormal 
conditions. 

There may be a combination of constipa¬ 
tion in one part of the bowel and a diarrhea, 
due to catarrh of another part. The diarrhea, 
because of the greater concern which it creates, 
may conceal the constipation. 

Dry Colitis. A dry colitis will produce 
constipation, since the secretions are materi¬ 
ally reduced. Inflammations may produce 
this dry condition of the colon, but many times 
the constipation itself produces it; thus the 
condition of the colon becomes such as to per¬ 
petuate the constipation, and again a vicious 
circle is produced. Usually in these cases 
66 




Causes of Constipation 


when normal bowel action can be established 
by hygienic care the colon again secretes its 
normal fluid and will no longer be dry. 

Perspiration. Where the perspiration is 
profuse the fluids of the entire body may be 
diminished and constipation may result when 
the intestinal secretions are called upon and 
thus reduced. 

Pain. Pain is rarely considered as a cause 
of constipation but during considerable pain, 
rheumatic or otherwise, the secretions are 
greatly retarded or entirely suppressed, espe¬ 
cially when the pain is in the abdominal re¬ 
gion, as in the abdominal walls, loins, or in¬ 
ternally as in the diaphragm, pelvis, etc. 
There is also a disturbance of functions gen¬ 
erally, through abnormal nerve reactions re¬ 
sulting from pain; and when present it will 
almost invariably produce a constipation that 
will not be overcome until the pain subsides. 

Emotions. Worry, fright, anger, grief and 
other depressing emotions, and physical or 
mental exhaustion will sufficiently reduce the 
intestinal secretions as to produce a delay in 
bowel action. We can readily see the effect 
produced by these upon the secretions when 
67 



Constipation 


we observe how dry the mouth becomes 
through a suppression of the salivary secre¬ 
tion during these emotions and conditions. 

Thyroid Gland Deficiency. As far back 
as 1899, E. Hertoghe, a Belgian physician, 
in articles on hypothyroidism described the 
influence of the thyroid in causing chronic in¬ 
testinal stasis. The effect of this condition 
upon the intestines is the reduction of the se¬ 
cretions of the canal, which results in dry and 
hardened bowel contents; whereas when the 
thyroid secretion is normal the intestines are 
stimulated naturally to secrete their normal 
amount of fluids to keep the feces soft and 
plastic. 

Liver Torpidity—Bile Deficiency. Au¬ 
thorities differ in their opinion as to the extent 
a torpid liver plays in the production of con¬ 
stipation; but almost all agree that at least 
fifty percent of the cases of intestinal stasis 
are due to, or associated with, liver disorders, 
and some authorities claim as high as ninety 
percent. 

An inactive liver results in a marked de¬ 
crease in the amount of bile secreted and 
passed into the bowel. The bile has several 


68 



Causes of Constipation 


functions, among which are: a stimulant to 
peristalsis; activator of intestinal secretions, 
thus helping to maintain normal moisture in 
the canal; helps in the emulsification of food 
fats; an intestinal antiseptic, thus preventing 
intestinal putrefaction with its many harmful 
effects upon bowel functions. It is one of 
the main stimulants to intestinal peristalsis 
and one of the most important agents of lub¬ 
rication, and when absent or secreted in de¬ 
ficient amounts the movements of the contents 
of the canal are certain to be greatly retarded. 
But the bile also has a very decided stimulat¬ 
ing effect upon the pancreas and causes this 
most important digestive gland to secrete its 
fluid, with its various ferments, in adequate 
amounts. Without this normal amount, di¬ 
gestion of all food is delayed. 

Over two-hundred years ago a famous 
Scotch surgeon, Arbuthnot, in The Nature 
and Choice of Ailments wrote “The inactivity 
of the gall occasions constipation of the belly”. 
His opinion that an inactive liver and its re¬ 
sulting deficiency of bile are prominent fac¬ 
tors in the causation of intestinal constipation 
is now known to be a definite truth. An ab- 


69 



Constipation 


normal quality of bile may have a similar ef¬ 
fect. 

Torpidity of the liver results from over¬ 
work of the organ by an excessive diet of the 
rich and heavy foods and by this abuse being 
continued over a considerable period of time. 
A genuinely pathological or structural change 
may take place in this organ as a result of in¬ 
flammation produced in the effort of the liver 
to perform all the excessive work that is de¬ 
manded of it. 

Obstructive jaundice is a frequent cause of 
constipation, since in this condition the intes¬ 
tinal tract is denied its requisite amount of 
bile which, among other functions, serves to 
soften the bowel contents and lubricate the 
intestinal canal. 

Other chronic affections of the liver may 
have the same result, among these being hepat¬ 
ic congestion, and atrophy or cirrhosis of the 
liver. Besides reducing bile quantity and 
quality, these produce a congestion of the 
veins carrying blood from the intestines to 
the liver, which leads to congestion in the in¬ 
testinal mucous membrane, with a thickening 
secretion also stimulates the peristaltic wave 

70 



Causes of Constipation 


of this membrane. Such a condition impairs 
secretion and peristaltic action of the intes¬ 
tines. 

Reduced Appendix Secretion. Another 

form of constipation from reduced secretions 
is that resulting from an insufficient appen¬ 
dicular function. This organ is supposed by 
many to have no definite function except to 
swell the bank account of surgeons; but by 
others it is thought to have a secretion, more 
or less oily in character, which stimulates the 
mucous membrane of the colon to throw onto 
the colon surface a mucous secretion to aid it 
in passing on its contents by lubrication; this 
secretion also stimulates the peristallic wave 
and helps regulate bowel action in this way. 
Intestinal inflammation and acute or chronic 
appendicitis (not to mention its surgical re¬ 
moval), cause a reduction or loss of this se¬ 
cretion, without which there is a dry colon, 
causing the feces to accumulate at the rectum 
where their moisture is eventually completely 
absorbed, making them hard and bullet-like. 

Pancreas Secretions. Functional or or¬ 
ganic disease of the pancreas (the secretion 
of which, as we saw in Chapter I, contains 
71 



Constipation 


enzymes for the digestion of all classes of 
foods) may so reduce or alter the secretions 
of this organ as to delay or prevent digestion 
of some of the food elements, especially the 
fats. One of the ferments of the pancreas is 
steapsin, or lipase, which acts upon the food 
fats, helping with the bile to break them up 
into fatty acids and glycerin. The former 
(fatty acids) unite with the alkalies of the 
intestinal contents to form a soap. Dr. W. 
H. Porter in “Eating To Live Long”, makes 
the claim that the glycerin formed by the 
steapsin upon fats has a similar effect on the 
bowels to glycerin injected directly into the 
bowel—that of a lubricant. In fact, both the 
glycerin and the soap are lubricants and help 
materially to produce normal passage of the 
bowel contents along the canal. They help 
also to maintain soft feces. This may result 
in diarrhea, but constipation will be the more 
probable result. 

Pituitary Secretion Deficiency. The pitui¬ 
tary gland is a small gland of internal secre¬ 
tion about the size of a pea, situated at the 
base of the brain. Schaefer in his work “En¬ 
docrinology” claims that the pituitary sup- 
72 



Causes of Constipation 


plies a secretion (called a hormone, as are the 
secretions of all internal secretion glands — 
because of their stimulating effect upon other 
similar secreting glands and other tissues) 
<vhich has the effect of maintaining muscular 
tone of the intestinal tract and of stimulating 
intestinal peristalsis. When this secretion or 
hormone is deficient in amount or quality the 
muscular tone is lowered, hence the muscular 
power is reduced. 

General Diseases—Fevers. There are 
many general diseases that have the effect of 
lessening the internal secretions or inhibiting 
normal peristaltic action of the intestines; 
these are especially the fevers. In some of 
these fevers, either general, or local within 
the intestines, there is frequently rapid ab¬ 
sorption of the fluid in the intestinal canal 
with the production of hardened feces which 
are difficult to expel. 

Chronic Lead Poisoning. It has long been 
known that one of the most stubborn forms 
of constipation, in fact an obstipation, is pro¬ 
duced by chronic lead poisoning. Painters 
especially are subject to this form of consti¬ 
pation and many of these have had to seek 
73 



Constipation 


other occupations in order for a cure to be 
established, and to prevent recurrence. In 
this case the secretions are markedly dimin¬ 
ished, but the alteration involves also the in¬ 
testinal musculature, and the nerve action may 
be reduced, even to complete paralysis. The 
kidneys may be greatly contracted also. This 
explains the extreme stubbornness of this 
form of constipation. 

The Enema Habit. I have prescribed and 
recommended the enema in thousands of cases, 
because I believe in its effectiveness as a tem¬ 
porary means of cleansing the lower bowel; 
and, through the removal of interference with 
the entire intestinal peristaltic wave, it is effec¬ 
tive to some extent as an indirect cleanser of 
the small intestine. I believe in its harmless¬ 
ness also, when it is properly employed as to 
frequency, amount and temperature of water, 
and the method of use. But I have seen some 
extremely intractible cases of constipation as 
a result of an irrational employment of the 
internal bath. 

Some individuals use an enema a few times 
and, finding that they feel decidedly more alert 
both mentally and physically, they get into the 
74 



Causes of Constipation 


habit of taking a bowel-cleansing treatment 
frequently, feeling that if a few applications 
of such treatment are effective the regular use 
would be beneficial; and they usually use too 
much water, possibly at too high a tempera¬ 
ture, and inject it with greater force than by 
gravity alone. I shall say here merely that 
the enema may be productive of extreme dila¬ 
tion of the colon, sigmoid and rectum with 
marked atony of the muscles of these struc¬ 
tures, with severe constipation as a result. A 
complete explanation of the possible harmful 
effects of this means of relief will be found in 
Chapter V under “Hydrotherapy—Water 
Treatment.” 

INCREASED FUNCTIONING 
(HYPERFUNCTIONING) 

Spastic Constipation. In any age, but es¬ 
pecially in or near middle life, there is a severe 
and very slowly yielding form of constipation 
resulting from a contracted state of the bowel; 
this is frequently called spasmodic or spastic 
constipation. Sometimes the bowel is con¬ 
tracted to such an extent that there is but a 
pencil-size canal. The discharge from the 
75 



Constipation 


bowels in these cases is very acid and usually 
of foul odor. In some cases we find this con¬ 
dition after certain cases of ulcerated colitis 
or chronic dysentery, also in erratic, hysteri¬ 
cal and neurasthenic women, especially when 
suffering from pelvic disturbances. The 
symptom complex of many of these patients 
is markedly neurotic in type. This form is 
found in a large number of old persons also, 
with no apparent definite cause. 

It has been claimed by some observers that 
this is the result of an internal secretion dis¬ 
order which produces an over-tone of muscles 
in certain sections of the intestines. The gen¬ 
eral condition of which this is a symptom is 
called, by these observers, vagotonia meaning 
excessive “tension” of the vagus nerve, one 
of the main sympathetic nerves of the viscera 
or abdominal organs. Probably in some cases 
this cause may be responsible for the condi¬ 
tion; but as a removal of intestinal contents 
and toxemia usually corrects the condition in 
time, it would indicate that this particular 
variety of constipation is the result of certain 
types of intestinal decomposition or fermenta¬ 
tion which irritate the mucous membrane and 


76 




Causes of Constipation 


the nerves and muscles of the intestines in such 
a way as to bring about the internal muscular 
spasms. 

Following chronic dysentery or an ulcerated 
colitis we occasionally find the spastic type of 
constipation. This bears out the theory that 
intestinal toxemia is the cause, or at least a 
cause, of this type. 

Many times the action of the main portion 
of the colon is retarded by a dilation of weak¬ 
ened muscular walls while at the same time 
the extreme lower portions of the colon are 
held in a state of spasm or fairly permanent 
contraction, thus giving a double cause for 
constipation but producing the main features 
of spastic constipation. The most character¬ 
istic sign of this is feces fairly hard and round, 
or small and sausage-shaped masses. 

Muscular Spasms. There are numerous 
conditions which produce muscular spasm in 
the anal sphincters, the rectum, and the sig¬ 
moid. Among these conditions are: an irri¬ 
table prostate gland, uterine diseases, ulcera¬ 
tion within the rectum, and strictures. By 
reflex action from the area directly affected, 
the intestinal tract at its lower extremity is 


77 



Constipation 


held in a state of spastic contraction, which 
retards either the complete downward descent 
of the fecal content or its escape from the 
rectum. Spasmodic or reflex strictures will 
have an effect similar to organic strictures, 
though the response to treatment of these 
cases is much more rapid and satisfactory. 

NERVOUS DISORDERS 

Neurasthenia—Hypochondriasis. Some 
individuals seem to have no other cause for 
their intestinal torpidity than “pure nervous¬ 
ness”. At times their bowels may be in ap¬ 
parently normal condition while at other times 
they are extremely sluggish, and this latter 
condition may be for the greater part of the 
time. It may alternate or be relieved occa¬ 
sionally by short sessions of diarrhea. These 
are people who become neurasthenics and hy¬ 
pochondriacs and spend so much time and en¬ 
ergy, not to say money, toward the relief of 
constipation. It is in this class of patients 
where we most frequently find worry as a 
contributing cause of the disorder. The con¬ 
stant worry over bowel inactivity, as well as 
78 



Causes of Constipation 


over the thousand and one other symptoms, 
is sufficient in itself in a considerable number 
of cases to bring about a condition of genuine 
constipation or to aggravate a mild constipa¬ 
tion into a severe one. Their constipation is 
usually the result of a lack of nerve force 
transmitted to the intestinal muscles—a con¬ 
dition technically referred to as “nervous in¬ 
hibition”. In such cases the constipation and 
the nervous disorder react upon one another: 
the constipation aggravating the nervous dis¬ 
order and the latter intensifying the constipa¬ 
tion—a condition that demands thorough 
treatment to rehabilitate bodily health. 

Spinal Causes. In a considerable number 
of cases there are spinal ligamentous or deep 
muscular contractions, or a combination of 
both of these, which interferes directly with 
the spinal nerves leading to the intestines, 
probably giving a certain degree of pressure 
to them or irritating them by the constant 
tension of fibres connected to the nerve sheaths. 
This interferes with the nerve supply to the 
intestinal muscles and mucous membranes and 
with the circulation to these structures; they 
fail to receive normal nerve impulses or if such 
79 



Constipation 


impulses are received the intestines fail to re¬ 
spond to them because of their muscular weak¬ 
ness. 

Sphincter Spasms. “Tight sphincters” is 
a recognized cause of constipation. Some 
causes of these tight sphincters have already 
been mentioned and include irritating intes¬ 
tinal contents, irritable prostate, etc. But 
some of these cases of spastic sphincters or 
of contractions elsewhere within the intestinal 
tract, as well as many other conditions respon¬ 
sible for constipation, are primarily the result 
of abnormal conditions in the spinal column. 
Occasionally there may even be a subluxation 
of the vertebrae—an actual slipping of one 
or more vertebrae out of alignment. 

That this spinal theory in regard to consti¬ 
pation is true, one need only to come in con¬ 
tact with numerous cases of more or less severe 
constipation, many of them of long duration, 
that have been corrected by spinal manipula¬ 
tive treatment alone; or in some cases by deep 
spinal massage. 

Strictures of various areas have either a 
direct effect, as when located within or near the 
intestinal tract, or an indirect or reflex action 


80 




Causes of Constipation 


when located elsewhere. When spastic sphinc¬ 
ters exist the trouble is not only localized in 
these sphincters but the entire intestinal peri¬ 
staltic wave is reflexly retarded and the con¬ 
tents more or less stagnate. We need only 
to note the effect of a very minute injection 
into the rectum, or the insertion of a small 
suppository or a rectal dilator, to secure a 
demonstration of the direct connection between 
the sphincter muscles or the mucous mem¬ 
brane of the rectum and the peristaltic wave 
higher up. 

Abnormal Nerve Functioning 

Every organ in the body functions through 
nerve action, and every organ or structure of 
the abdomen receives its main nerve supply 
from the spinal column. If this supply is inter¬ 
fered with, at or near its source, there will be 
either an irritation with increased action or a 
suppression of impulses with more or less par¬ 
tial paralysis or inactivity. If this involves 
the intestines there will be constipation or 
diarrhea as a primary result and constipation 
always as the later result. If it involves the 
diaphragm this structure may descend less 
81 



Constipation 


feebly during respiration and this important 
muscle is prevented from aiding the intestines. 

Central Nervous System. Any other or¬ 
gan or structure that has to do with intestinal 
activity, whether in regard to the secretions, 
position, or muscular activity, may be suffi¬ 
ciently disturbed as to result in constipation. 
Certain conditions of excess irritability of the 
central nervous system or of the sympathetic 
nervous system, or conditions of more or less 
inactivity from very slight to complete paraly¬ 
sis, may result in intestinal stasis. In insanity 
there is very apt to be severe constipation, or 
frequently merely a failure to respond to body 
demands. 

Tubercular Meningitis. Certain conditions 
of the brain produce very marked constipa¬ 
tion; for instance, tubercular meningitis has as 
a symptom constipation of a more pronounced 
character than any other condition having an 
equal degree of fever. Brain tumors are also 
productive of obstinate degrees of constipa¬ 
tion. 

Spinal Cord Diseases. Certain diseases of 
the spinal cord also have as a symptom obstin¬ 
ate constipation, as, for instance, locomotor 
82 



Causes of Constipation 


ataxia, and apoplexy of the spinal cord. These 
results are due to a direct inhibition of the 
peristaltic function through the nerve centers, 
either of the brain or cord. 


MECHANICAL AND STRUCTURAL 
DEFECTS 

Ptosis, or Prolapse. The correct action or 
functioning of any organ depends upon its 
normal structure, no less than upon its correct 
innervation. When for any reason the organ 
is prolapsed no function will be perfect, 
though it may continue to perform its duties 
sufficiently that the individual may be un¬ 
aware of any abnormality; but in time the re¬ 
tarded function will be certain to result in 
more marked symptoms or in other conditions 
so pronounced that its damage will be unmis¬ 
takable. 

The stomach is very subject to prolapse but 
not more so than the large intestine. The 
convolutions of the small intestine are natu¬ 
rally very irregular and they occupy most of 
the center of the abdominal cavity and, except 
for the duodenum or first part, are rarely pro- 
83 




Showing the normal position of the large intestine or 
colon in relation to the small intestines and also to the 
stomach. For a better understanding of the extent of 
the stomach see figure on page 241. 


84 







Causes of Constipation 


lapsed, or at least their prolapse is not readily 
discernible. 

Some of the worst cases of constipation are 
the result of sagging of some of the abdominal 
viscera. One of the well known physicians of 
an earlier generation used to say in attempt¬ 
ing to explain life’s vicissitudes that we needed 
less to fear the “many slips twixt the cup and 
the lip” than the “many twists twixt the mouth 
and the rectum.” One of the great English 
Surgeons (Dr. Arbuthnot Lane), by clinical 
experience and the radiograph, has determined 
numerous points along the gastro-intestinal 
tract that are most subject to ptosis or pro¬ 
lapsus. These points are: 

(1) The end of the duodenum farthest from 
the stomach, at which point there may be a 
very abrupt kink. This may result in a dila¬ 
tion of practically the entire duodenum. 

(2) The ileum at its connection with the 
cecum. This is really a kink produced in the 
ileum by a dropping of the cecum, rather than 
a dropping of the ileum itself. 

(3) The left extremity of the transverse 
section of the colon or large intestine—at the 
splenic flexure. The colon at this point is 

85 



Constipation 


fixed but the ascending colon may be very low, 
causing the transverse colon to ascend diagon¬ 
ally from right to left across the abdomen in¬ 
stead of di¬ 
rectly across 
the abdo¬ 
men. This 
fixed point 
of the splenic 
flexure 
makes it ne¬ 
cessary for 
the contents 
to climb 
high when 
the colon 
sags. 

(4) The 
next point 
down the 
colon is the 
sigmoid 
loop. The 
peculiar arrangement of this gives one the im¬ 
pression that it was designed especially to 
retard materially the onward progress of the 
86 



Showing a mild prolapsus of the 
transverse colon; also a very long 
sigmoid colon and rectum; either 
of these conditions may exist alone. 





Causes of Constipation 


intestinal contents. Such is very probably 
true, in order that the whole amount of nourish¬ 
ing elements will be absorbed from food; and 
it is only the lack of proper dietetic habits that 
make it a contributing cause of constipation. 

(5) Finally, there is in some instances a 
marked elongation of the rectum itself, which 

naturally re- 
quires a 
longer time 
for the ac¬ 
cumulation 
of a suffici- 
ent fecal 
mass for 
stimulation 
t o evacua¬ 
tion. 

Still a n - 
other point 
to be men¬ 
tioned is the 
hepatic or 
liver flexure 

Showing a more marked prolapsus « ,, i 
of the transverse colon; also differ- ui tile colon, 

ent positions of the long sigmoid Sometimes 
and rectum. 



87 







Constipation 


Ballooning of 


this flexure falls forward and may be almost 
as low as the right groin, causing the ascending 
colon to loop over on itself. Normally the 
hepatic flexure should be as firmly fixed to the 
posterior wall of the abdominal cavity as is 
the splenic flexure. 

Ballooning, or Dilation, 
the colon has 


the same ef¬ 
fect as pro- 
lapse. It 
may be so 
dilated that 
a normal 
amount of 
contents is 
not s u f f i - 
ciently stim¬ 
ulative to 
create nor¬ 
mal peristal¬ 
tic waves, or 
the muscula¬ 
ture may be 
so weak that 
the peristal- 



Showing a kink at the hepatic 
(liver) flexure, by prolapse of the 
colon at this point; also somewhat 
prolapsed sigmoid and elongated 
rectum. 


88 








Causes of Constipation 


tic waves are inefficient. It is usually dietetic 
errors or the abuse of the internal bath which 
produces this condition, though sometimes it 
results from strictures of the rectum or from 
very tight anal sphincters which cause a re¬ 
tention of the colon contents until they have 
assumed sufficiently large portions to affect a 
stretching of the colon. 

In some instances atony of the rectum re¬ 
sults in the dilation of this section of the 
colon to great size. It may sometimes reach a 
diameter of four or five inches. 

Strictures. There are certain definite me¬ 
chanical or structural causes of constipation, 
sometimes more direct than many of those thus 
far referred to. Strictures from many causes 
are fairly frequent causes of constipation. 
These may result from inflammations (the 
usual cause) or from operations and operation 
scars. They are different from adhesions in 
that they are within the lumen of the canal, 
and when they are in the intestines they draw 
together the walls of the tube and thus reduce 
the size of the opening. They may also extend 
across the opening, sometimes as direct adhe¬ 
sive bands, and may even occlude the canal. 

89 



Constipation 


But strictures farther up in the digestive canal 
may also be responsible for the development 
of intestinal stasis—probably by making it im¬ 
possible for the individual to use any but liquid 
or very soft foods, as in stricture of the eso¬ 
phagus, or by interfering with the passage of 
more solid contents, as in stricture of the py¬ 
lorus, or exit 


of the stom¬ 
ach. 

Adhesions 
and Bands. 
Adhesi ons 
that unite 
the outer 
wall of one 
section of 
the intestine 
to that of 
another, o r 
the intestines 
to some 
other abdo¬ 
minal organ 
or structure 
— possibly, 



Showing kinks at both hepatic and 
splenic colon flexures, through pro¬ 
lapse of the colon; also somewhat 
dilated rectum. 

90 









Causes of Constipation 


though rarely, to the wall of the abdomen itself 
—produce a direct mechanical interference to 
the lumen of the intestine or to the normal 
peristaltic action. These adhesions result from 
numerous causes, among which are peritonitis, 
perityphlitis (inflammation about the cecum), 
appendicitis, and other severe intestinal 
inflammations; also pelvic inflammations or 
major abdominal operations. The inflamma¬ 
tion may produce bands of tissue, more or 
less ligamentous in structure, uniting some 
part of the intestine with some other part or 
structure; these are similar to adhesions and 
produce the same results. 

Intussusception—Invagination. In some 
rather rare instances one section of the intes¬ 
tine will dilate and “swallow” an adjoining 
section. This is more frequent in children than 
in adults. Naturally this enclosure of one 
layer of intestine within another will prevent 
the transmission of the peristaltic wave and an 
absolute stasis of the contents is certain to re¬ 
sult. This condition calls for prompt and 
effective treatment, not infrequently surgical. 

Twists and Kinks (Volvulus). The in¬ 
flammations mentioned as producing adhesions 
91 



Constipation 


or bands may result in certain twists or kinks 
in the small or large intestine, and when one 
of these occurs it has the same effect as the 
invagination just mentioned—the complete 
blocking of the canal. 

Strangulated Hernia. When a part of the 
gut protrudes through a hernial opening and 
becomes kinked or locked in this position, a 
condition similar in symptoms and effects to 
intussusception is produced. One of these 
symptoms is obstinate constipation; in fact, 
an absolute blocking of the intestinal canal— 
and there is also vomiting, with in time fecal 
vomiting. This is a very serious condition and 
calls for prompt action—not so much merely 
to produce normal bowel movements, but to 
prevent gangrene from pressure, and blocked 
circulation of the part of the gut that protrudes 
through the hernial opening. 

Prolapse. Prolapse has already been men¬ 
tioned and will be referred to here only 
because of the direct pressure and interference 
it may produce. 

Growths and Tumors 

Abnormal growths or tumors are frequent 

92 



Causes of Constipation 


causes of constipation because of the pressure 
they yield upon the intestines, directly nar¬ 
rowing the lumen, or of pressure upon an¬ 
other organ in such a way that this organ will 
interfere with the caliber of the intestinal tract. 
They are also sometimes so situated that they 
interfere with secretory functions. These 
growths may be either in the intestines therp- 
selves or they may be anywhere outside of the 
intestines in or about the abdomen. They may 
be pathological or physiological. 

Hemorrhoids—Other Tumors. Hemorr¬ 
hoids are one form of pathological tumor on 
a small scale. These come and go in some in¬ 
stances, with alternating constipation and 
normal bowels; especially when they are the 
internal variety they more or less occlude the 
anal canal. Other tumor masses are cancer, 
fibroids, etc., all of which may have as a direct 
or indirect effect a more or less severe condition 
of constipation. They may be located in the 
uterus, ovary, prostate, rectum, or elsewhere. 
Sometimes when these tumors or hemorrhoids 
are located within the rectum or at the anus, 
or when there are fissures in the anus or rec¬ 
tum, it is frequently the pain which produces 
93 



Constipation 


the constipation or which causes the individual 
to suppress bowel action in order to prevent 
suffering. In other cases the irritation is suffi¬ 
cient to produce spasms and the result is 
similar to spastic constipation. 

Pregnancy. The most pronounced case of 
physiological tumor is pregnancy. It is uni- 
yersally known that the pregnant woman is 
frequently obstinately constipated as a result 
of the interference with the peristaltic action 
of the intestines and by pressure against the 
sigmoid and rectum. Probably in some cases 
the disturbance of internal secretions during 
pregnancy may be responsible for a general 
reduction of physiological processes, among 
which would be bowel elimination. Extra- 
uterine pregnancy (pregnancy in the ovary, 
Fallopian tube, or abdominal cavity) will 
have the same constipating tendency, though 
usually more pronounced at an earlier stage 
than in normal pregnancy. 

Enlarged Prostate and Uterine Malposi¬ 
tions. A condition having the same effect as 
a tumor is an enlarged prostate gland or a 
prolapsed, retroflexed, or retroverted uterus. 
These structures are normally in immediate 
94 



Causes of Constipation 


contact with the thin wall of the rectum and 
any enlargement or backward displacement 
naturally reduces the lumen of the rectum and 
delays defecation. Prostatitis, because of its 
irritability, may reflexly disturb rectal and 
sphincter action also and result in constipation. 

Foreign Bodies and Coccyx Deflection. 
In rare instances foreign bodies may find their 
way into the lower bowel and directly inter¬ 
fere with the peristalsis or the onward prog¬ 
ress of the bowel contents. The coccyx or 
extreme lower tip of the spinal column is in 
direct contact posteriorly with the rectum. In 
rare cases this bone may be bent far forward, 
from falls or other injuries, and have the same 
effect as a tumor pressing from the outside, 
thus lessening the caliber of the intestine. 

External Constrictions. Then there are 
constrictions which in some cases are responsi¬ 
ble for constipation. Contractions of the ab¬ 
dominal wall and of the chest by corsets or 
tight lacing of girdles, stays and tightly drawn 
belts directly interfere with the downward 
descent of the diaphragm produced by deep 
abdominal breaths. This reduces the massage 
effect of respiration and the activity of the 
95 



Constipation 


intestinal canal is thereby materially lessened. 
A further effect of these is the removal of the 
lateral and anterior pressure of the external 
abdominal muscles, or of rendering these 
muscles so weak that their pressure effect is 
too slight to be of value. 

Malformations. In some few instances 
there are inherited or acquired malformations 
of the intestines which interfere with one or 
more of their processes and constipation may 
be a constant condition. 

Localized Rectal Swellings. In the rec¬ 
tum there may be a number of conditions be¬ 
sides those already mentioned, which delay 
bowel evacuation. Certain of the sphincter 
muscles or rectal valves may be hypertrophied 
or enlarged as a result of chronic colitis or 
ulceration or some other inflammation. The 
anal sphincters themselves may be enlarged. 
Such swelling naturally interferes by lessen¬ 
ing the size of the canal, but they also render 
the muscles more sluggish to respond to the 
relaxing impulses necessary for normal, regu¬ 
lar evacuation; furthermore, they reflexly dis¬ 
turb peristalsis farther up the canal delaying 
the passage of waste to the rectum. 

96 



Causes of Constipation 


GENERAL AND ORGANIC DISEASES 

Cretinism. Cretinism, a congenital condi¬ 
tion of thick-set dwarfishness, with absence of 
thyroid gland and many characteristic signs 
of sub-functioning of vital organs and glands, 
has, usually, a constant and intractible consti¬ 
pation. 

Anemia. Anemia, whether primary or 
secondary, is frequently associated with con¬ 
stipation, sometimes as a cause of it. In other 
cases the two conditions arise from the same 
general causes. Anemia is frequently the re¬ 
sult of dietetic or hygienic errors. 

Diabetes. Diabetes produces an intestinal 
stasis sometimes fairly obstinate in nature. 
This may be because of the digestive secretions 
of the pancreas being deficient in amount or 
defective in quality, or it may be the result of 
general metabolic decline. Diabetes is almost 
always the result of an excessive diet, in con¬ 
nection with poor hygienic care. 

Arteriosclerosis. Arteriosclerosis in time 
produces a constipation in many cases through 
the direct interference with the blood supply to 


97 



Constipation 


the intestinal mucosa and musculature, as the 
blood vessels of these structures become thick¬ 
ened and hardened. Every case of arterio¬ 
sclerosis can be prevented, likewise materially 
benefitted, by proper diet, etc. 

Lithemia—Gout—Rheumatism. In lithe- 
mia, or the condition where the blood contains 
an excess of uric acid and from which gout, 
rheumatism, eczema, bronchitis, asthma, or 
other symptoms may be the result, there is al¬ 
ways sluggishness of bowel action and of other 
eliminative functions. This sluggishness may 
be and usually is a cause of the lithemia, but 
the condition itself perpetuates and increases 
the inactivity. In gout and rheumatism there 
is invariably a constipation before the onset of 
the acute attacks. This bowel inactivity is 
doubtless a prominent factor in producing 
these attacks, by producing or increasing the 
toxicosis. But because of the pain itself and 
the aggravation of it by motion, the constipa¬ 
tion is aggravated and the sufferer fails to 
respond to the infrequent and rather feeble 
urge to evacuate the bowel contents until, usu¬ 
ally, a drug cathartic makes the responses 
urgent. These conditions will never develop 
98 



Causes of Constipation 


if one’s mode of life in every way is health- 
maintaining and disease-preventing. 

Chronic Organic Diseases. Chronic di¬ 
seases of the heart, lungs, kidneys and liver 
create a congestion in the veins which drain the 
intestines, which results in a sluggishness of 
muscular action, thus retarding peristalsis and 
bringing on constipation. These organic 
diseases do not develop where one’s personal 
hygiene is constructive and conservative, and 
not destructive. 

INDICATIONS OF CONSTIPATION 

From the numerous causes mentioned we 
find that constipation may indicate anyone or 
more of the following: Abdominal tumor; ad¬ 
hesions; amenorrhea; anemia; anal fissure; 
apoplexy of the spinal cord; ascites; atony of 
the bowel or stomach; cancer of the bowels, 
kidneys, pancreas, rectum, stomach, or uterus; 
cirrhosis of the liver or stomach; concretions; 
cretinism; diabetes; dilated colon or stomach; 
duodenal or intestinal catarrh; gout; hemorr¬ 
hoids; strangulated hernia; hysteria; influ¬ 
enza; insanity; intussusception (swallowing of 
99 



Constipation 


one part of the intestine by another) ; jaun¬ 
dice; kinked bowel (volvulus) ; lead poisoning; 
lithemia or presence of uric acid in the blood; 
locomotor ataxia; meningitis; mucous colitis; 
neurasthenia; ovarian tumors; paralysis— 
acute ascending, intestinal, or of the dia¬ 
phragm; peritonitis; pregnancy, normal or in 
the Fallopian tube, prostatic hypertrophy (en¬ 
largement) ; prostatitis; prolapse of stomach, 
intestine, colon, sigmoid, or rectum; retro¬ 
flexion or retroversion of the uterus; scybala 
or hard fecal concretions; stricture—of the 
bowel, esophagus, pylorus or rectum; sweat¬ 
ing, when excessive; tumor of the brain; ulcer 
of the stomach. 


SUMMARY 

From the great variety of causes enumer¬ 
ated above one might imagine that an almost 
equal variety of treatment would be necessary 
in order to affect all cases favorably. As a 
matter of fact, for practical purposes there are 
comparatively few causes of constipation that 
we really need to consider. Many of the lesser 
causes tend to produce the few main causes 
that will require consideration. 

100 



Causes of Constipation 


I have explained how dietetic errors and 
wrong habits directly produce constipation and 
how they produce other conditions which 
cause, perpetuate, or aggravate the intestinal 
sluggishness. I have explained how many of 
the functional, organic, and general causes 
may themselves result from dietetic faults and 
habit blunders. 

But some of the mechanical and structural 
causes are also the direct result of the same 
faults. Pelvic and abdominal inflammations, 
tumor growths, etc., while they cause struc¬ 
tural change and become mechanical causes of 
constipation when fully developed, would not 
even begin to develop if one’s mode of living 
were in all respects according to Nature, and 
not injurious. 

Organic diseases are the direct result of de¬ 
vitalizing food and habits, or are the indirect 
result of them through a more direct cause, 
which may be acute or chronic “infections.” 

If one lived in such a way as to keep his 
blood in a normal condition, free from toxins 
and plentifully supplied with disease-combat¬ 
ing or disease-preventing elements, it is 
doubtful if one could develop constipation, 
101 



Constipation 


even from constant association with lead and 
paints and other substances containing this 
constipating mineral element. 

One’s nerves would be at a normal tone, 
neither hyperfunctioning nor hypofunction¬ 
ing, if there were no habits, dietetic or other¬ 
wise, to take them from the normal. The spine 
and spinal nerves and muscles would, in the 
majority of cases, function normally and with¬ 
out unnatural irritability and contractions, or 
sluggishness and relaxation. 

Except for the spinal cases resulting from 
injuries of various kinds, for the comparatively 
few congenital malformations and defects of 
the alimentary canal or spine, for those result¬ 
ing from operations (which themselves may 
have been performed for conditions prevent¬ 
able by correct diet and habits), and for the 
cases resulting from destruction of tissue, as in 
some spinal paralyses and organic diseases, 
there are practically no cases of constipation 
that cannot be said to result from one of two 
or three causes. 

Briefly summed up, then, we may say that 
practically all cases of constipation or intes¬ 
tinal stasis are due simply to neglect of ordi- 
102 



Causes of Constipation 


nary common sense hygiene— to wrong foods, 
to wrong eating, and to wrong habits of life . 
The various injurious foods and combinations 
of foods and the wrong habits may vary con¬ 
siderably, so again we sum up our causes into 
just three: nervous excitability, enervation , 
and muscular atony or relaxation. Whatever 
the other causes, they usually result in an irri¬ 
tability of nerves or a loss of nerve impulses, 
or in weakness of the intestinal muscles; and 
the nerve excitability, resulting in hypertonic 
muscles, is comparatively uncommon, and 
when present will in time, if allowed to con¬ 
tinue, result in atonicitv through lowering of 
nerve impulses, as a result of exhaustion. 

Therefore, in Chapter V, which is devoted 
to the treatment of constipation, we shall for 
the most part coniine our attention to means 
of normalizing the nerves controlling intestinal 
activity and the muscles of the intestinal tract 
and abdomen particularly. 


103 



CHAPTER IV 


Symptoms, Results and Effects 

SYMPTOMS 

TAR. ARBUTHNOT LANE of London 
says: “Chronic intestinal stasis, which I 
believe to be the prime factor in the produc¬ 
tion of very many diseased conditions, is of 
enormous importance and we cannot spend too 
much time or thought in unraveling the many 
problems which it presents.” 

There is a surprisingly wide difference in 
the way individuals are affected by constipa¬ 
tion, due apparently to the degree of suscepti¬ 
bility or to an absence of this factor. Even 
with the most persistent constipation, some 
persons may continue to enjoy excellent 
health, while with very mild or acute cases 
other people may have very marked symptoms. 
However, the usual case of retention of waste 
and residues in the intestinal tract, for a 
longer time than a particular individual is ac¬ 
customed to, will give rise to discomfort and 
other unpleasant symptoms. 

104 


Symptoms, Results and Effects 


Pressure symptoms will result naturally 
from a mass in the rectum; but the toxic effects 
that result are not so much from the rectal 
accumulation—which are in solid condition 
and naturally covered with a protective coating 
of mucous—as from an absorption of poison¬ 
ous materials higher up in the bowels, where 
the contents are liquid. 

The nature of these symptoms depends to a 
considerable extent upon the nature of foods 
consumed. Some foods will produce certain 
abnormal products and combinations of toxins 
that have a decidedly different effect than those 
of other foods which produce different toxins. 
Whatever the effects, they are largely due to 
autotoxemia. Toxemia or autointoxication 
has recently become recognized as a more or 
less direct cause of many diseases, perhaps 
particularly those of mental or nervous char¬ 
acter, at any rate they are far more pro¬ 
nounced in those of nervous temperament. 

The symptoms that are usually or at least 
frequently present as a result of this intestinal 
stasis and general toxic condition are head¬ 
aches, dizziness, mental sluggishness or depres¬ 
sion; coated tongue, foul breath and taste in 
105 



Constipation 


the mouth, and loss of appetite; scattered or 
general itching, restlessness; general lassitude, 
debility and a feeling of tiredness; yet some¬ 
times the lack of elimination of waste and the 
products of body metabolism produce an irri¬ 
tation of the brain and a mental awakeness 
sufficient to prevent normal sleep. One may 
have such marked insomnia or at least suffi¬ 
ciently disturbed sleep that the general con¬ 
stant fatigue may result from this inadequate 
rest. Dreams, especially of an erratic nature, 
will come to constipated individuals, and small 
children may have night terrors or nightmares 
from no other cause than intestinal torpidity, 
and the resulting intestinal disturbance. 

The digestion becomes more and more de¬ 
fective as the stomach cannot take care of its 
duties, while being prevented from disposing 
normally of its digested products. Greater 
and greater discomfort after meals frequently 
follows, and there is a sense of weight in the 
abdomen, probably direct in the stomach. The 
skin, particularly of girls, becomes “muddy,” 
earthy and sallow, with frequently dark rings 
under the eyes, and pimples and acne are fre¬ 
quent in both sexes. 


106 



Symptoms, Results and Effects 


RESULT. AND EFFECTS: GENERAL 

One of the most important considerations in 
regard to constipation is the effect it produces 
when there is general disease. There is no 
case of acute or chronic disease, regardless of 
what organ or structure or extent of the body 
is affected, that is not materially aggravated 
or prolonged by intestinal stasis. 

Abscesses, acne, eczema, hives and psoriasis, 
adenoids, asthma, boils and carbuncles, cramps, 
deafness, eye troubles, goiter, gonorrhea, hay- 
fever, headache, heart and kidney disorders, 
impotence, lung and bronchial affections, men¬ 
strual and other pelvic troubles—especially 
ovarian and prostatic troubles—neuralgias and 
neuritis, varicocele and other varicosities, etc., 
are the more or less local troubles that are af¬ 
fected; acidosis, anemia and other blood dis¬ 
orders, convulsions of whatever nature, dia¬ 
betes, fevers, insanity, paralysis and other 
nerve disorders and general diseases—these 
and others are all made worse or more diffi¬ 
cult of correction by a retention of digestive 
waste products through constipation. 

Repair of Wounds. The repair of wounds, 
107 



Constipation 


including those made by surgical operations, 
is much less rapid, and infection is much more 
liable, because of the contaminated blood, and 
because the blood has not been able to absorb 
from the intestinal tract sufficient of the re¬ 
parative elements. Broken bones heal more 
slowly in these cases, and tumors, growths and 
inflammations anywhere in the body reduce or 
decrease less rapidly or increase more rapidly. 

Golds, Catarrh and Susceptibility to Tem¬ 
perature Changes. Because of the blood-pol¬ 
lution by the insufficient elimination in consti¬ 
pation, one is more susceptible to colds, there¬ 
fore the results of colds may be said to be due 
somewhat directly to the constipation; and, in 
fact, more or less serious results are frequently 
directly traceable to colds which were in turn 
traceable to constipation. The same may be 
said of catarrh. 

The toxins absorbed and the viscous (thick) 
blood thus produced result in such constriction 
of the peripheral capillaries or the circulation 
within these minute vessels that the blood of 
the skin and extremities is not kept in normally 
rapid circulation; one suffers, because of this, 
from cold extremities and general chilliness. 

108 



Symptoms, Results and Effects 


The toxins that should escape through an 
active skin are retained to produce extra work 
for mucous membranes of the intestines, lungs 
and for the kidneys, so that catarrh of mucous 
membranes is a logical result, as are coughs, 
bronchitis, kidney weakness, etc. 

Because of the unbalanced circulation and of 
the toxins present in the body one may have 
transient flushes, even though ordinarily easily 
chilled. One does not react well to either ex¬ 
treme in outside temperature—being colder 
than the average individual in cold weather 
and sometimes suffocatingly hot in warm 
weather—because the whole heating and ven¬ 
tilating mechanisms are out of adjustment. 

High Blood Pressure—High Tension— 
Arteriosclerosis. As stated, the excess of 
toxins absorbed from and retained by the inac¬ 
tive bowel more or less occludes the superficial 
blood vessels; this makes it necessary for the 
heart to beat much stronger than is natural in 
its endeavor to continue the circulation at nor¬ 
mal rate. The combination of increased heart 
action and increased resistance raises the blood 
pressure. This will in time produce arterio¬ 
sclerosis or hardening of the arteries, as Na¬ 
il 09 



Constipation 


ture, in an effort to guard against perpetual 
increased pressure against them, fortifies the 
arterial walls. The absorbed toxins themselves 
add to the development of thickened arterial 
walls. Some of these, of an earthy mineral 
nature, are precipitated into these structures 
from the blood as it proceeds more and more 
slowly through the vessels. Headache and 
nosebleed may be fairly frequent symptoms of 
the arteriosclerosis or increased tension. 

Low Blood Pressure—Low Tension. 
The heart may, instead of beating with greater 
force, merely beat more rapidly, tending in 
time to a more or less permanent functional 
disturbance, as a result of the over-work, or 
from the toxins or both. 

The heart may become irritable—easily up¬ 
set, palpitating, with occasional skipping of 
beats. In this condition and in the other 
functional and organic disturbances, and in 
those individuals who develop more marked 
general depression instead of increased ten¬ 
sion, there will be a low blood pressure, with 
all the attendant reduction of functional ac¬ 
tivity. At night while reclining the heart beat 
may be heard in the ear on the pillow and 
no 



Symptoms, Results and Effects 


this may disturb the sleep and equanimity. 

Premature Senility. The absorption of 
toxins and consequent pollution of the blood; 
the partial occlusion of the capillary system, 
with reduction of general metabolism and 
elimination, and of dry, defectively nourished 
skin; and the hardening or abnormal relaxa¬ 
tion of the arteries, not to mention the effect 
upon the sexual organs, frequently produce 
the premature aging in individuals with a sus¬ 
ceptibility to this class of symptoms. Consti¬ 
pation is one of the most prominent causes of 
lines and wrinkles in certain people and of the 
aging not due to years. 

Goiter—Internal Secretion Disturbances. 
We have long known that goiter may be the 
direct result of toxins absorbed from some 
source. Intestinal stasis and putrefaction of 
intestinal contents may or may not be the be¬ 
ginning of thyroid disturbance and goiter, but 
any case of goiter or abnormal thyroid func¬ 
tioning is always aggravated greatly by pol¬ 
luted blood from a clogged, inactive colon. 
And as the thyroid gland secretes a vitally ne¬ 
cessary internal secretion that, besides its gen¬ 
eral tonic effect, is a regulator of other internal 
ill 



Constipation 


secretion glands, when it is caused to secrete 
abnormally there will be a general disturbance 
of all the internal secretions. The normal bal¬ 
ance of these secretions being positively essen¬ 
tial to health, their unbalance starts a train of 
abnormal conditions the extent of which can 
never be foretold; even the mental and psychic 
forces may be greatly altered. 

Rheumatism—Rheumatoid Arthritis— 
Tuberculosis. The latter two of these condi¬ 
tions, and appendicitis, are considered by Dr. 
Lane of London to be due largely to intestinal 
stasis, and in regard to them he has this to say: 
“In my experience a patient cannol develop 
either of these diseases (except in case of tu¬ 
bercle by innoculation), unless the resisting 
power to the entry of organisms, or, in other 
words, the vitality of the tissues of the body, 
has been depressed by poisons which circulate 
through them in chronic intestinal stasis.” 

I agree with Dr. Lane as to the influence of 
the intestinal inactivity in the production of 
these diseases, but in these, as in other diseases, 
I hold that the “organisms” referred to (the 
germs) are merely the result of and rarely 
112 



Symptoms, Results and Effects 


the cause of the disease or the disease 
symptoms. 

Immediately before the onset of typhoid 
fever there may be a diarrhea, which may lead 
one erroneously to exclude constipation as a 
cause, but I believe there is no case of typhoid 
fever without a period of constipation before¬ 
hand. If the intestinal tract is kept clean 
typhoid fever cannot develop. As with 
typhoid fever, no case of appendicitis can 
develop where constipation does not exist. By 
this I do not mean that a daily bowel move¬ 
ment may suffice; it is necessary, to prevent 
this condition as well as any other symptom 
or effect of constipation, that the bowel elimi¬ 
nation be in direct proportion to the intake of 
solid nutriment. 

Rheumatism and gout, and a number of 
other diseases and abnormal conditions result¬ 
ing from lithemia or the rheumatic or gouty 
diathesis (tendency), are also invariably due 
to constipation as at least an associate factor, 
and are many times due to no other cause than 
constipation. 

Pains, Unclassified. Ia fact pains for 
which no definite inflammatory condition ex- 


113 



Constipation 


ists may be the result directly or indirectly of 
costiveness. There may be pains in the back, 
especially in the lumbar region; pains in either 
the left or right side; at the pit of the stomach; 
in the groin; or in the rectum or perenium; or 
even down the thigh. Colic may also be a 
painful condition resulting from constipation. 
The joints may become stiffened and the seat 
of pains that are indeterminate in character, 
and there may be a crunching, creaking noise 
and sensation when the joints are flexed and 
extended. 

Vision and Hearing. The specks before 
the eyes that follow constantly the shifting of 
the eyes, are due in many cases to toxins ab¬ 
sorbed from a constipated bowel. The failing 
vision in many of these and other cases is due 
in large measure to the decline of body fluids 
and structures and functions resulting from 
the aging effect of the toxins retained and ab¬ 
sorbed. Cataracts and other eye diseases and 
inflammation and eye fatigue are aggravated 
by, due to, or made possible by this same 
sluggishness. 

Hearing defects, however, are usually not 
so closely related to constipation, but any de- 
114 



Symptoms, Results and Effects 


feet, whether in hearing or of an inflammatory 
nature as in discharge, etc., is aggravated by 
it or their relief is more retarded and compli¬ 
cations more liable. 

RESULTS AND EFFECTS: LOCAL 

Some of the general symptoms and effects 
that have been considered appear in many in¬ 
dividuals with a certain susceptibility before 
or without the development of local symptoms 
and effects other than the infrequent or insuf- 
ficent bowel evacuation. But in a considerable 
number of constipation victims there will be 
local manifestations of a more or less marked 
degree, as the result both of the pressure of the 
retained rectal and colon contents and the ir¬ 
ritation and toxemia. These symptoms and 
effects naturally vary in different cases, be¬ 
cause of the varying nature and extent of the 
accumulations and the toxemia produced, and 
the individual susceptibility. 

Local Effect from Pressure 

Local Distention—Dilation. As is to 

be expected, the first local effect of retained 
feces will be a distention of the rectum and, 


115 



Constipation 


if a sufficient amount of residue be retained, 
of the colon. Usually this will be temporary 
at first and the structures will return to nor¬ 
mal when evacuation has been brought about. 
However, even in acute cases where there has 
been considerable undue stretching of the 
musculature of the gut, there will be some loss 
of tone with incomplete return toward normal. 

But in chronic cases there is very apt to be, 
and usually is, a dilation of the part of the 
canal subjected to the distention, and in time 
a more or less complete atony of muscles and 
mucous membrane will result. 

Hemorrhoids (Piles). The pressure of 
retained residue in the rectum upon the mesen¬ 
teric and hemorrhoidal veins prevents their 
drainage, with resulting engorgement of them. 
The mucous membrane and other structures 
will also be engorged and this, together with 
the absorption of toxins to further reduce their 
tone, will give rise to some form and degree of 
piles, or hemorrhoids. This pressure and the 
irritation coming from it may also set up an 
inflammation, the resulting swelling of which 
may produce such a distention of the local tis¬ 
sues and blood vessels as to result in the 
11G 



Symptoms, Results and Effects 


hemorrhoidal distention. The congestion of 
these vessels may also be the result of a torpid 
liver, but this may likewise be partially the 
result of the rectal congestion. A torpid liver 
may produce or aggravate piles by backing up 
the drainage. 

Ulceration — Typhlitis — Enteritis. Ul¬ 
ceration of the rectum or colon or both may 
be a direct result of waste retention. Some¬ 
times catarrhal inflammation confines itself to 
a local area, especially in a region of the ilio- 
cecal valve; inflammation here is called 
Typhlitis. This may increase and become a 
perityphlitis, which is a peritonitis involving 
the cecum and appendix. Inflammation of the 
cecum and appendix is one of the most com¬ 
mon of all outcomes of constipation. 

One or more sacculi, or small pouches along 
the colon, may be arbitrarily selected by the 
contents as a place of hiding. More and more 
accumulations take place until the sacculi are 
greatly distended. Direct injury may result 
to the mucous membrane or the contents of 
the bowel may undergo such fermentation and 
putrefactive processes as to result in conges¬ 
tion of the tissues from irritation. This then 


117 



Constipation 


becomes a point of “infection” which may 
spread over the colon; or it may be the point 
of local inflammation with, as a next step, 
ulceration. Even perforation may result in 
some cases when the ulceration is sufficiently 
extensive and the intestinal contents kept 
toxic in nature. 

Enteritis is very frequently present as a 
consequence of intestinal inactivity. This also 
is brought about usually by the fermentation 
and putrefaction producing an irritation and 
from this follows the local engorgement of the 
mucous membrane and its blood vessels. This 
is the reason for the frequent alternation be¬ 
tween constipation and diarrhea in some cases. 

While many operations have disclosed that 
the appendix does become inflamed, swollen, 
even pus-filled, there have been innumerable 
operations for appendicitis when this little 
organ was perfectly normal, but where the 
cecum, or the tissues immediately around the 
cecum, were inflamed. It is impossible to de¬ 
termine, except by operation, which structures 
are inflamed, since the symptoms may be iden¬ 
tical. I may say here that unless the pains 
considered characteristic of appendicitis are 
118 



Symptoms, Results and Effects 


the result of an acute pus appendix, operation 
is rarely necessary, and many times not even 
then. 

Strictures. The inflammation may be so 
extensive that when by some means the intes¬ 
tinal canal is cleared sufficiently for healing to 
take place, the scarred tissue draws the walls 
of the intestines sufficiently to reduce their 
caliber greatly, thus resulting in partial occlu¬ 
sion of the gut. Sometimes the healing of the 
inflammation directly draws together the walls 
of the affected part of the intestine, with the 
same effect. 

Impaction—Occlusion. A result that may 
be expected in severe constipation is fecal im¬ 
paction. When the rectum does not expel its 
contents regularly moisture is absorbed, since 
one of the functions of the colon is to take up 
the prepared nourishment present in the colon 
in liquid form. This absorption normally 
semi-solidifies the contents but when it is car¬ 
ried beyond the normal the contents may be¬ 
come extremely large and of stony hardness; 
this may end in direct occlusion of the bowel 
and nothing short of digital (finger) or other 
manipulation will break up sufficiently for 
119 



Constipation 


passage such masses as sometimes accumu¬ 
late. Finish such treatment by an oil enema. 

Fissures—Fistulas. The former are small 
and painful cracks, sometimes becoming ul¬ 
cers, and are usually located immediately 
within the anus. Generally there will be a 
small external pile situated behind the fissure. 
This condition is caused by constipation, com¬ 
monly of the variety associated with hard 
knotty feces that injure the mucous mem¬ 
brane. 

Fistulas are abnormal canals between the 
rectum and the surface, though they may not 
completely connect the two points. They come 
from either the rectal or surface side and 
extend varying distances outward or inward. 
When the opening is internal, whether com¬ 
plete or blind, it is located just above the in¬ 
ternal sphincter. Some injury to the mucous 
membranes of the rectum is the original direct 
cause, but constipation is almost always the 
cause of this mucous-membrane injury, espe¬ 
cially when the stools are large and hard. The 
bowel may be so polluted by foul waste that 
an abscess forms at the side of the injury as a 
result of the irritation and lack of normal cir- 


120 



Symptoms, Results and Effects • 


culation of pure blood to bring about a hasty 
repair. 

Prolapsus Ani — or Prolapsus Recti. 

This condition usually occurs in children but 
may happen at any age. It consists of a pro¬ 
trusion of the mucous membrane of the lower 
rectum through the anus. Sometimes even the 
muscular coat will protrude. General weak¬ 
ness may be the root of the trouble but con¬ 
stipation is frequently an immediate cause, 
especially when the bowel activity has con¬ 
tinued sufficiently long to lower the tone of 
the tissues, or when the constipated bowel has 
become subjected to sufficiently irritating con¬ 
tents to produce diarrhea, with rectal relaxa¬ 
tion. 

Tile-like Coating of Colon. I have known 
several cases where the prolonged retention of 
food waste in the colon has resulted in com¬ 
plete absorption of the fluid contents; the 
accompanying reduced activity of the intes¬ 
tinal muscles has permitted a tile-like coating 
to be constructed or deposited around the 
entire wall of this part of the gut. In some 
instances this has been at least one-quarter of 
an inch thick. Naturally in these cases the 
121 



Constipation 


peristaltic wave of the bowel has been abso¬ 
lutely checked or at least it has had no effect 
upon the contents free within the channel re¬ 
maining. In these cases and where there have 
been accumulations in the sacculi along the 
sides of the colon, a certain amount of liquid 
contents flows along the center of the gut. 
These cases are very subject at times to a 
fairly severe diarrhea and in some instances 
the cause of the diarrhea escapes detection for 
a long time. 

Women seem to be more subject to this 
form of constipation-diarrhea than men; and 
where they have given a history of constipa¬ 
tion for a long time with occasional attacks of 
diarrhea present, possibly nausea and vomit¬ 
ing, this condition should be suspected and a 
thorough examination of the intestinal tract, 
especially of the colon, should be made. Not 
infrequently fever, at times symptoms of 
typhoid fever, are observed in cases of this 
type. 

Enteroliths. These are intestinal “stones” 
appearing most frequently in elderly people, 
though they may occur at any age. They 
result from accumulation and long retention 
122 



Symptoms, Results and Effects 


of feces in the sacculi along the margins of the 
colon, the moisture being entirely absorbed— 
similar to the condition described above. 
There may be particles broken off or by other 
means expelled occasionally, or they may be 
small when formed in isolated pockets. By 
some these are thought to be accumulations 
around a nucleus of cellulose or other indi¬ 
gestible substance, but they would not be pos¬ 
sible without constipation. In their passage 
they may produce considerable pain, possibly 
fissures or fistulas, and they may also irritate 
the prostate and seminal vesicles in males. 

Flatulence—Rumblings. Flatulence, or 
an accumulation of gas in the stomach or in¬ 
testines or both, is one of the most frequent 
effects of constipation. Gases may be pro¬ 
duced by chemical changes taking place in the 
long-retained feces, or the blocking of the 
rectum may so long delay action higher up 
that fermentation results with a development 
of gases in considerable amounts. This delay 
in action may even affect the stomach and fer¬ 
mentation take place there. The gases may 
be retained and produce bloating and disten¬ 
tion with more or less pain; or they may be 
123 



Constipation 


belched from the stomach; or sometimes passed 
from the anal exit; but they may be absorbed 
into the blood with a production or aggravation 
of autotoxemia. If they are retained in the 
intestines their constant shifting may result 
in the abdominal rumblings or noises fre¬ 
quently heard—called borborygmi. This lat¬ 
ter condition, however, may result in those 
cases with tile-like linings or any other case 
associated with occasional diarrhea. 

Hernia—Rupture. This condition cannot 
be said to be due to constipation, but the undue 
straining that is usually exerted to free a con¬ 
stipated bowel, by the marked increase of intra¬ 
abdominal pressure, may be a direct cause of 
an enlargement of the hernial opening. And 
even more serious complications may be 
brought about by constipation: The delayed 
peristaltic action and the congestion may so 
lower the intestinal tone that they make it 
more probable that a loop of the “lazy gut” 
will enter the hernial opening, possibly to be¬ 
come strangulated, then gangrenous. 

Sacral and Ovarian Neuralgia. An over¬ 
loaded sigmoid or rectum is not infrequently 
the cause of neuralgia of the sacral and 
124 



Symptoms, Results and Effects 


ovarian nerves by pressure upon the lower 
spinal nerve plexus or, in case of a prolapsed 
ovary, directly upon this gland or its nerves. 

Special Effects Upon the Pelvic Organs 

Very few people consider the danger of 
constipation to the pelvic organs of both sexes. 
Without doubt .Nature has provided sufficient 
room for all of the pelvic organs in health, 
with room enough for them to perform their 
various functions; but the close proximity of 
the numerous organs makes any blockade cap¬ 
able of producing the initial step in disorders 
that may eventually result in more or less com¬ 
plete destruction of functional ability. The 
ultimate result in these cases is not confined 
to the pelvis itself but involves practically 
every organ, tissue and structure in the body, 
with a wide variety of symptoms and disorders. 

Effects Upon Either Sex. Bladder Weak¬ 
ness — Enuresis. In either sex the crowding 
of the hollow bladder may be so marked as to 
limit directly its capacity, thus requiring 
emptying more frequently than normal. The 
pressure and resulting congestion or the ab¬ 
sorption of toxic material may produce suffi- 
125 



Constipation 


cient irritation to give rise to an inflammation 
which, if not relieved by cleansing the bowels 
of the irritating contents, may lead to general 
inflammation of the organs with possibly an 
extension upward to the kidneys. 

Effects Upon the Male. Prostatic Trouble . 
The male is very frequently subject to invol¬ 
untary escape of procreative fluids as a result 
of the extreme pressure on the prostate and 
seminal vesicles by large masses of waste in 
the rectum. The pelvic organs must be espe¬ 
cially strong if these results do not come from 
severe constipation. This pressure and result¬ 
ing loss is much more pronounced when there 
is considerable straining, with its increase of 
the already considerable pressure. This cre¬ 
ates a marked irritability of the prostate and 
the seminal vesicles, establishing in some in¬ 
stances prematurity and in others a prostatic 
hypertrophy and the thickening or hardening 
of the vesicles. It will be clearly seen how this 
is possible by observing the illustrations of 
the normal and of the constipated male 
rectum. 

Varicocele. It is a well known fact that 
one of the most frequent causes of varicocele 
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127 















Constipation 


in the male is constipation. This is explain¬ 
able by the fact that the left spermatic vein 
passes upward behind but in close contact with 
the rectum. A loaded rectum will then create 
such pressure upon this vein that it cannot 
drain the blood from the left side of the 
scrotum at normal rate; congestion is thereby 
produced in the scrotum and the testicle, with 
gradual enlargement of the left veins of the 
scrotum, and varicocele is the result. This 
may lead eventually even to atrophy of the 
affected testicle. 

Effects Upon the Female. Prolapsus . By 
observing the illustration of the female pelvis 
one may readily understand how serious con¬ 
stipation may be to the female pelvic organs. 
It will be observed that the vagina is directly 
in front of the rectum and that the uterus is 
slightly above. Constipation may practically 
obliterate the vagina by filling and enlarging 
the rectum and the enlarged rectal contents 
may press the uterus considerably above its 
normal position. This will weaken the uterine 
supports and when the fecal prop is removed 
the uterus may sag much below its normal 
fairly high position in the pelvis. 

128 




129 
































Constipation 


Congestion — Malpositions. In numerous 
instances, especially in constipation, the rec¬ 
tum may be to one side or other of the uterus 
and may press the uterus to the opposite side 
or may press it directly forward, probably 
producing a permanent displacement of the 
organ. When the uterus is in one of these 
malpositions it more easily becomes congested, 
swollen and inflamed—a condition' causing 
proliferation of the tissue cells, which adds in¬ 
creased weight to the organ. In some cases 
this increased size and weight may in turn 
produce a fairly severe and serious occlusion 
of the rectal canal, thus preventing or hinder¬ 
ing escape of its fecal contents. Here, again, 
will be produced a vicious circle—a constipa¬ 
tion producing uterine congestion or malpo¬ 
sition, this in turn aggravating the constipa¬ 
tion and likewise further aggravating the 
uterine pathology, and so on ad infinitum. 

In numerous instances these effects in the 
female are produced through a sense of false 
modesty only. Young maturing girls espe¬ 
cially often fail to respond to the calls of 
Nature when they are urgent, and as a result 
the rectal contents increase, become hard and 


130 



Symptoms, Results and Effects 


firm and yield greater and greater pressure, 
with the results mentioned. 

Dysmenorrhea — Painful Menstruation . 
Many cases of painful menstruation, or dys¬ 
menorrhea, and the sensation of fullness and 
distention in the organ of the female pelvis are 
strictly the result of this constipation pressure. 

Leucorrhea. The most prominent cause of 
leucorrhea is pelvic congestion, which pro¬ 
duces a 4 ‘low grade inflammation” of the 
mucous membrane of the vagina and of that 
lining the uterus. As constipation produces 
this congestion it is, therefore, indirectly the 
cause of leucorrhea. But if the leucorrhea is 
the outcome of other irritation or of general 
impairment of health, constipation will ag¬ 
gravate it, and delay or prevent its correction. 

Chlorosis . Chlorosis, or 4 'green sickness,” 
not infrequently results from, or at least is 
associated with, fairly severe and protracted 
cases of constipation in girls, and their entire 
system may become extremely flabby, soft, and 
tone-less. 

Local from Irritation and Autotoxemia 
Liver Congestion—Jaundice. Occasion- 


131 



Constipation 


ally an obstinate case of constipation is 
responsible for the development of jaundice. 
The functions of various organs, especially 
those that have to do with digestion, are re¬ 
tarded during constipation, partly because of 
the direct blocking of the fecal mass and 
partly by the toxemia produced. The liver is 
one of these organs which frequently becomes 
less active; but, as food is usually continued to 
be consumed, bile is constantly produced and 
the liver becomes congested, and the blood is 
forced to take up some of the bile elements. 
There may be an extension of catarrhal in¬ 
flammation up the bile ducts from the duode¬ 
num. In the attempt to dispose of this 
secretion-excretion, Nature passes it, together 
with other waste matters, through the excre¬ 
tory pores of the skin. This gives rise to the 
greenish tint observed in jaundice. The odors 
emanating from such a person are usually ex¬ 
tremely unpleasant— much more so than in 
the usual case of jaundice. The undergar¬ 
ments, even after a day’s wear, appear to have 
been dyed a greenish-yellow. It is surprising 
to many that these individuals usually suffer 
little inconvenience or few symptoms; this is 

132 



Symptoms, Results and Effects 


explainable by the fact that Nature is expell¬ 
ing the waste elements, even though not 
through the normal, natural channel. 

Duodenal and Intestinal Catarrh— 
Tuberculosis. I have mentioned a general 
catarrhal condition as being produced or ag¬ 
gravated by constipation; but local catarrh of 
the mucous membrane lining the entire digest¬ 
ive canal may follow an irritation by poison¬ 
ous substances too long retained, also by the 
general toxemia due to the absorption of these 
poisons. But a catarrhal condition may be 
the cause of constipation also, as we have al¬ 
ready seen. Catarrh of the digestive canal 
reduces the digestive secretions or their qual¬ 
ity and effectiveness, also the absorption of 
nutriment and the elimination of waste; but it 
causes an increase of the mucous secretions, 
which accounts for the more or less persistent 
loose, watery stools that are noticed after the 
condition has developed. As tuberculosis is 
practically invariably incubated in the ali¬ 
mentary canal, and as catarrh is one of the 
fore-runners of this universal plague, it will 
be understood how constipation may be an 
underlying cause of tuberculosis, and why the 
133 



Constipation 


intestinal activity should be restored to normal 
so as to prevent the development, or to bring 
about a correction of either of these diseased 
conditions. 

Mucous Colitis. A condition which has 
some appearances of catarrh is mucous colitis, 
a sub-acute or chronic inflammation of the 
mucous membrane of the colon. Large slimy 
masses resembling shreds and patches of mem¬ 
brane may be passed rather frequently, this 
condition usually alternating with constipa¬ 
tion; there are usually colicky pains during 
the periods of diarrhea. Patients who have 
this ailment are usually neurotic or neuras¬ 
thenic, or at least they become so after the 
disorder has continued for some time. If the 
intestinal mucous membranes are not irritated 
by constipation and by fermentation, putre¬ 
faction, and the resulting abnormal gases and 
chemical compositions, it would not become 
inflamed to such an extent as to produce the 
chronic state of colitis. 

Germs. While I am convinced that germs 
are present as scavengers only, in practically 
all cases of whatever abnormality, these germs 
do sometimes produce substances in the 

134 



Symptoms, Results and Effects 


process of their activity which may be and 
probably frequently are injurious. Efforts 
should always be made to keep the intestinal 
tract clean, because of the direct harmful 
effect of the presence of waste substances and 
their absorption, but also that there may be 
established no breeding place for germs. For 
the undue retention of decomposing wastes in 
a constipated bowel makes the generation of 
germs more assured and encourages their mul¬ 
tiplication; it makes possible their extension 
beyond the limits of their normal habitat; and 
their harmful products may be absorbed and 
scattered throughout the system, with an ag¬ 
gravation of toxemia and a lowering of vari¬ 
ous organic activities. 

INDIRECT EFFECTS 

Upon the Kidneys—Bright’s Disease— 
Enuresis. The work of the kidneys is to 
carry off in solution many of the toxic elements 
resulting from digestion and the body meta¬ 
bolism. In cases of constipation these ele¬ 
ments are markedly increased and concen¬ 
trated, and the more severe the constipation 
the more serious may be an irritation of the 
135 



Constipation 


delicate lining of the kidney tubules. In fact, 
these tubules may be so irritated as to become 
inflamed, and Bright’s disease will be the out¬ 
come. 

In any case of constipation, even before or 
without the development of structural change 
in the kidneys, the urine is usually dark and 
the specific gravity is high. The well-known 
“brick dust deposit” in urine that has been 
allowed to stand is more frequently the result 
of constipation than of any other cause. 
Urination is more frequent than normal, espe¬ 
cially in women, but there may be in others a 
retention of urine, or a greater difficulty in 
evacuating the bladder contents because of 
the rectal impaction. Sometimes it is only 
during the relaxation of sleep that the bladder 
is more easily emptied and this condition re¬ 
sults in enuresis, or bed-wetting, especially in 
children. 

It is claimed by some authorities that germs 
may reach the kidney pelvis by migration and 
thus set up the inflammation resulting in 
nephritis. This I do not believe, or, if it does 
occur it does so extremely rarely. The in¬ 
flammation is the outcome of demanding and 


136 



Symptoms, Results and Effects 


forcing the kidneys to eliminate such concen¬ 
tration of toxic elements that their structure 
is partially destroyed through the resulting in¬ 
flammation—and germs are present wherever 
there is inflammation and vitally lowered or 
destroyed cells. The same condition that 
leads to this inflammation pollutes the blood 
stream to such an extent that the kidneys 
cannot repair quickly and normally, and their 
structural change therefore increases. In 
this manner also, in cases of susceptibility, 
constipation may bring about nephritis or 
Bright’s disease as a sequel. 

General Wasting and Cachexia. As a 
consequence of habitual constipation and the 
various functional and structural effects upon 
the digestive organs due to it, a condition of 
slow starvation may develop, with loss of body 
tissues and energy. Naturally, the greater 
the degree of functional inactivity and struc¬ 
tural change the more pronounced will be the 
effects upon the entire body. As the result 
of the peculiar starvation and blood changes 
and toxins absorbed into the body, and those 
produced in the abnormally functioning cells, 
there appears in these cases a peculiar lifeless 
137 



Constipation 


grayish tint to the skin, known as cachexia. 

REMOTE EFFECTS 

Mastitis or inflammation of the breast, 
chronic inflammation of the pancreas, gall 
stones, and abnormal growths may be present 
in certain cases as indirect remote effects of 
long-continued constipation, especially when 
the diet is particularly “heavy” and consists 
of foods and combinations which produce 
more markedly poisonous substances. 

Thus it will be seen that innumerable 
symptoms and results may be brought about 
by reduced activity of the intestinal canal, 
especially of the large intestine or colon. A 
comparatively slight sluggish condition is very 
liable to produce serious disorders in those 
people especially susceptible, and when the 
blood is polluted by the average conventional 
diet, which is far greater in amount than is 
required to maintain all processes within the 
body, and when the constipation is continued 
over a long period of time, the consequences 
are much more apt to be extremely serious in 
nature regardless of the susceptibility. 


138 



CHAPTER Y 


TREATMENT 

T^ROM all the causes that have been given 
A for constipation, as well as the multitude 
of symptoms produced by this order, one may 
well wonder if the trouble can possibly be cor¬ 
rected. Dr. Watson of Edinburgh has 
roughly grouped the cases into three classes: 
First, fairly mild cases that respond to 
simplest measures; second, those of a severe 
nature yet which, by protracted, conscientious 
following of strict hygienic measures eventu¬ 
ally yield; and a third group that have devel¬ 
oped complicating structural changes which 
require surgical interference for the correc¬ 
tion of them and the constipation. While 
this classification may be satisfactory in a way, 
the gradations of severity in constipation are 
such that they really cannot be grouped; 
there is every form and degree of constipation 
from the very mildest to the most severe. 
And while I will admit that there are cases 
demanding surgical work, I cannot admit that 
this surgery must be performed for the symp- 
139 


Constipation 


tom of constipation; it is only when constipa¬ 
tion is one of numerous symptoms resulting 
from a condition of tumor, adhesions, etc., that 
surgery may be required. 

Fortunately (so far as relief and correction 
are concerned) the great -majority of cases 
are due practically entirely to errors in diet 
and hygiene. Wrong living in these respects 
may have been continued sufficiently long that 
constipation has resulted in fairly widespread 
changes in structure or function or both, but 
the proper regimen continued with sufficient 
energy and duration will slowly undo damage 
created, and not only constipation but the 
direct, indirect and remote results may like¬ 
wise be remedied or greatly relieved. In any 
case the cause should be searched for and, if 
found, properly treated. I wish to emphasize 
the fact that there is no case of constipation, 
except those rare ones which result from in¬ 
jury, organic destruction and markedly ab¬ 
normal structures, that can be corrected by any 
means that does not include correction of one’s 
mode of life. In all cases hygienic methods 
of living and an outdoor life of a proper na¬ 
ture must be adopted, and there must be a 
140 



Tkeatment 


reduction of stress, strain, worry, depressing 
emotions, and dissipation of energies. 

In any individual, prevention of constipa¬ 
tion should be assured if possible. But what¬ 
ever factors will be instrumental in preventing 
it will be helpful in correcting the disease after 
it has become established. 

I shall not consider here the treatment of 
those cases of constipation that depend upon 
structural defect, except those produced by 
or associated with constipation of long stand¬ 
ing—atony, prolapse, and dilations. Cases 
resulting from tumors, adhesions and stric¬ 
tures may be remedied or greatly relieved 
without surgical interference, but treatment 
to accomplish these benefits would be so dif¬ 
ferent and specific for the individual case, and 
would probably require such direct assistance 
from some one thoroughly understanding the 
conditions and treatment, that it would be im¬ 
practicable to attempt to give needed sugges¬ 
tions in this volume. Happily these cases are 
extremely rare. 

Habit formation—Solicitation. As men¬ 
tioned earlier, we find that the various organs 
of the body are very susceptible to habit-form- 
141 



Constipation 


ation. As the habit of postponement may 
produce constipation, soliciting the bowels 
regularly when constipation exists will help 
to train them back to the habit of evacuation. 
At some specified time during the day, prefer¬ 
ably immediately or shortly after breakfast, 
the constipated person should isolate himself 
in a convenient and comfortable health room 
and concentrate his thoughts upon the one 
act of bowel evacuation. He should remain 
on the toilet for from fifteen to twenty or even 
thirty minutes each time. Some people take 
a newspaper, book or some other reading ma¬ 
terial to the toilet room and more or less con¬ 
centrate the mind upon the subject of the 
printed matter. Others take some special 
personal problem with them and attempt to 
unravel it at this time. Such habits must be 
corrected when one is attempting to overcome 
constipation. When aware that he would be 
for some time in inconvenient circumstances 
for relieving the bowels, one who has noticed 
no desire to vacate the bowels has been able to 
bring about satisfactory evacuation merely by 
concentrating upon the act. This result has 
been secured in innumerable instances, and 

142 



Treatment 


the method will prove surprisingly effective 
in many cases, as a part of the treatment. 

For some time a case of pronounced con¬ 
stipation may show no response whatever to 
this solicitation, but if persisted in it will yield 
results, especially if efforts are made at the 
same time to correct other causes of the con¬ 
dition. Consequently when any attempt to 
secure results by this simple means fails, one 
should not be discouraged but should continue 
day after day in the attempt. But if results 
are unsatisfactory at first one should wait 
until the same time the following day or until 
the specified time later in the day. 

While immediately after breakfast is usually 
the best time for this attempt, in some in¬ 
stances it may be better after the evening 
meal. If one is a hearty eater and still con¬ 
stipated, the attempt may be made at each end 
of the day. In any case it should be made 
always at fixed hours. 

After the bowels have discharged a part of 
their content there may be a feeling that the 
act has been completed and yet another mass 
of waste may be retained in the immediate ex¬ 
tremity of the rectum. One should not be in 
143 



Constipation 


haste to leave the toilet stool, as in these cases 
where masses are retained the response of the 
nerves of the rectum will become blunted and 
they will later fail to respond. Therefore all 
residue that is in the rectum should be evacu¬ 
ated before the act can be considered complete. 

Respond to Nature’s Call. Many people 
find themselves in some duty or pleasure 
which they do not care to leave for the mo¬ 
ment, and unless the call to evacuate is 
extremely urgent they postpone the relief 
until a more opportune time. When the time 
comes that they can spare the few minutes 
necessary it is very probable that the call has 
subsided; at any rate, they have succeeded in 
blunting and reducing the responsiveness of 
the rectal nerves, and in postponing just so 
much longer the complete correction of their 
trouble. Parents and school teachers are re¬ 
sponsible for many severe cases of constipa¬ 
tion in children because they demand of the 
children that they wait. Particular care 
should be taken to secure relief for the child 
at the first moment it seeks such relief. In 
this way a host of more serious troubles may 
be prevented in later childhood and, in fact, 
144 



Treatment 


throughout life. Whenever there is the slight¬ 
est call to relieve the bowels, this call should 
be given preference over all other demands 
upon one’s time; for every postponement 
hastens the development or aggravation of 
constipation or materially retards any tend¬ 
ency to correction of the trouble. 

Importance of Drinking Water. Many 
cases of constipation are the result of an in- 
sufficent quantity of water. It is not neces¬ 
sary for one to take extremely large quantities 
of this fluid, but from six to eight glasses 
should be taken during each day. I have been 
informed that some Japanese make a habit of 
drinking at least a gallon of water a day. This 
appears to me to be an excessive amount, or at 
least more than is required for the main¬ 
tenance of body fluids and proper fluidity of 
the intestinal contents. A glass of water 
every two hours during waking hours would 
be a good plan to adopt, but whether or not 
the water is taken at regular intervals, there 
should be a daily consumption of an equal 
amount. Never use it to wash down deficiently 
masticated food, but take it when the mouth is 
empty, with or between meals. 

145 



Constipation 


Hot Water. A glass or two of warm or 
hot water before retiring may. help to retain 
sufficient moisture in the intestinal tract that 
by morning there will be a natural call for 
evacuation. The night time is the logical time 
for drinking hot water, since it is the period 
of relaxation; and the additional relaxation 
created by the hot drink will not tend to de¬ 
feat any other means employed for the cor¬ 
rection of constipation. Taken in the morning 
hot water may prove effective as a laxative for 
a few times, but this effect will be less and less 
pronounced and the relaxation produced by 
it will tend in time to aggravate the condition. 

Cold Water. A glass or two of cool or cold 
water (not iced) before breakfast will fre¬ 
quently so stimulate the peristaltic action of 
the intestines that their contents will be passed 
on fairly rapidly to the rectum and there seek 
their escape. Cold water at night may be 
satisfactory for maintaining the fluid content 
of the bowels, and it may be taken with safety, 
but in some instances it has a tendency to pre¬ 
vent complete relaxation, for a short time at 
least; also in some cases it may have the effect 
of stimulating the bowels to increased peristal- 
146 



Treatment 


tic action, resulting in a stimulation to evacu¬ 
ate during the sleep, when one is not so apt 
to detect the call. This condition, if repeated 
without response, is very apt to result in a 
dulling of the rectal nerves and an aggrava¬ 
tion rather than a correction of constipation. 
In the morning, then, when it is desired to 
recover tone from the relaxation of sleep, the 
cold water will prove of value—not merely in 
its action upon the bowels alone, but upon the 
whole digestive tract and the entire system 
generally. 

DIETETIC TREATMENT 

I believe my statement will not be disputed 
when I say that at least seventy-jive percent 
of all cases of constipation result from wrong 
diet —either poor food, harmful combinations, 
improper preparation, or insufficient mastica¬ 
tion, etc. It will be seen, then, that diet will 
be the biggest single factor in the correction 
of the trouble. Our modern, super-refined 
foods cannot but tend toward the development 
of the condition, and where the condition is 
established such foods will not only retard but 
absolutely prevent its correction. 

147 



Constipation 


In other cases, instead of foods from which 
all cellulose has been removed, there has been 
an over-use of the coarse foods } which results 
in such continuous irritation that the nerves 
are eventually exhausted and fail to respond— 
and there may be actual inflammation. 

Thorough Mastication. As bolting the 
food is a frequent cause of constipation, any 
one suffering from this disorder must avoid 
such an inclination and must insure thorough 
insalivation of his food. 

The majority of people think all that is re¬ 
quired is for food to be in small particles, soft 
and mushy and easily swallowed. This is re¬ 
sponsible not only for countless cases of con¬ 
stipation, but for disorders of all kinds. It 
must be remembered that the stomach has no 
teeth and that it can do only a fairly limited 
amount of trituration or refining of the foods 
which enter it. Foods that do not require 
mastication for making them soft and fine 
should either be eliminated from the diet or 
should receive special attention in the matter 
of mastication, that the saliva may be incor¬ 
porated with them as much as with foods that 
absolutely demand mastication. 

148 



Treatment 


The mixture of saliva with the food in the 
mouth is of equal if not greater importance 
than the mere softness of the food. The more 
thorough the mastication, the more plentiful 
will be the supply of saliva and the greater 
the natural nerve stimulation necessary for the 
secretion of digestive juices throughout the di¬ 
gestive canal. This insures greater moisture 
in the canal, as well as a more plentiful supply 
of digestive ferments, and tends to more 
nearly normal peristaltic movements and more 
thorough and regular evacuation. 

Moderation. Moderation in the use of food 
may seem to some an ineffective means of cor¬ 
recting constipation, but I wish to assure my 
readers that, as many cases of constipation 
are the result of inhibition of nerve impulses 
and undue stimulation through an overload¬ 
ing of the digestive canal, these will be cor¬ 
rected where the quantity of food is reduced to 
that amount which less completely fills the in¬ 
testinal tract. 

Few are aware of the fact that the more one 
masticates his food, the less he can consume. 
When food is thoroughly masticated the taste 
buds are stimulated by the various flavors; in 
149 



Constipation 


time they cease to be stimulated, which indi¬ 
cates that the appetite has been appeased. 
These can only be stimulated further by a 
change of food—by those foods having dif¬ 
ferent or stronger flavor than those already 
consumed. This accounts for the ability and 
tendency to take desserts and other dishes of 
various kinds after one has filled his stomach 
to an uncomfortable degree. If highly spiced 
foods are taken as appetizers, or if condiments 
are added to the food, the taste buds are fur¬ 
ther stimulated and a greater quantity can be 
consumed. This over-crowding has, as I have 
previously stated, a direct effect in producing 
constipation. 

The amount of food at each meal must be 
kept sufficiently low that there will be no feel¬ 
ing of fullness or distress; in fact, it is best 
to end the meal while still slightly hungry. 
There should be no piece-mealing, especially 
when this condition is being remedied. Food 
taken into the stomach after the process of 
digestion is well established disturbs the 
rhythm of the intestinal peristalsis and cannot 
fail to defeat the corrective tendency of a mod¬ 
erate quantity of foods of a proper character, 
150 



Treatment 


as well as the other means being employed to 
overcome the trouble. 

The Fast. The probabilities are that you 
have never given the digestive organs of your 
body a rest, yet at frequent intervals you have 
given your brain and muscles a rest. The in¬ 
testines need a rest no less than do other parts 
of the body, but especially is this true after 
they have been over-worked for years until 
they are more or less exhausted. You have 
whipped them into action innumerable times 
by drugs, coarse foods, enemas, etc; give them 
now the treatment they should have had long 
ago—a rest from activity. 

A complete rest of the intestinal tract is best 
accomplished by means of the fast. During 
this procedure solid contents are expelled and 
no additional solid substance is added. This 
freedom from the process of digestion allows 
the mucous membranes, the muscles, and the 
nerves of the intestinal tract to recover their 
tone and their functional powers. 

Those who are acquainted with the fast are 
fully aware of the paradoxical increase of 
strength of organs and structures during the 
period of abstention from food. As the ali- 
151 



Constipation 


mentary canal is the only structure of the body 
directly affected by food, this fast brings 
about a more direct and radical change upon 
the various structures of this canal than upon 
any other part of the body, and in a shorter 
period of time. When the diet following the 
fast is of a proper character the increased tone 
secured by the fast not only will be retained 
but added to. 

Preparatory Bowel Cleansing. I heartily 
condemn drug laxatives as ordinarily em¬ 
ployed, but in the case of stubborn constipa¬ 
tion the beginning of the radical treatment— 
the fast—may, with benefit, consist of an 
effective dose of some saline laxative. Such 
laxatives secure their results by drawing into 
the intestinal tract, from the blood and adja¬ 
cent tissues, a considerable portion of the body 
fluid. They also stimulate the mucous mem¬ 
brane of the intestines to secrete more mucus, 
in order to dilute further the mildly irritating 
laxative. This increased fluid in the intestinal 
tract and the increased peristalsis thereby pro¬ 
duced hastens the expulsion of the solid con¬ 
tent. While the reactive effect of such a 
laxative—a still further decrease in functional 


152 



Treatment 


activity—is the same as that from any laxa¬ 
tive or cathartic taken at any other time, the 
effect is usually entirely overcome within 
twenty-four hours or so. The diet during this 
time and for some time after should consist of 
nothing but water, or at most the juice of a 
few oranges or of a small amount of other 
fruit; and the reaction is full established with¬ 
out detriment. But when one is eating regu¬ 
larly, this reaction 1 6 further reduced func¬ 
tional activity inyariably results in an aggra¬ 
vated condition of sluggishness and retention. 

The bowels require an absolute rest for a 
longer or shorter period of time. The laxa¬ 
tive removes from them the solid material upon 
which they would be obliged to function, or at 
least from which the toxic elements would be 
absorbed. After they have been emptied by 
the laxative, there is nothing to interfere with 
their relaxation and rest and the start toward 
recovery of nerve and muscle tone. This laxa¬ 
tive is especially recommended for the more 
aggravated cases of constipation, where re¬ 
tention of waste and resulting toxic effects are 
marked. But it should he taken once only, at 
the beginning of the fast . 

153 



Constipation 


The fast or fruit juice diet, in addition to 
cleansing the intestinal tract and allowing 
recovery of tone, prepares the entire digestive 
apparatus for the milk diet or any other fur¬ 
ther corrective diet that may follow; thus is 
insured a more complete digestion and ab¬ 
sorption of the nourishing elements which are 
necessary for maintaining the intestinal tone 
and for a more satisfactory elimination of 
waste elements. 

Length of the Fast. It would be highly in¬ 
advisable to attempt to suggest the length of 
this fast or fruit juice diet. The duration and 
severity of constipation and the local and gen¬ 
eral systemic effects resulting from it, also the 
natural vitality of the patient, must all be 
taken into consideration in determining the 
length of time without solid food. Ordinarily 
the more severe and serious the constipation 
and its effects, the longer will the fast be 
necessary; and, strange as it may seem, the 
easier will the fast be to the patient. This is 
accounted for by the fact that the greater the 
accumulation of toxic elements in the system 
the more is a fast or other restricted dietetic 
measure required, and because the body will 
154 



Treatment 


utilize the stored up tissue or wastes as fuel. 
Where the condition is of comparatively short 
duration or but slight, with few or insignifi¬ 
cant symptoms, a shorter fast or fruit or other 
limited diet will usually suffice. Mild cases 
may require only two or three days of com¬ 
plete rest from all solid food, whereas some 
severe cases will demand from seven to ten 
days or longer of this rest. 

The Milk Diet. From my years of experi¬ 
ence with thousands of cases of chronic and 
acute diseases I have found most of them asso¬ 
ciated with some degree of constipation. I have 
seen also countless cases of constipation alone, 
which as yet had produced no further reduc¬ 
tion of functional activity or physical efficiency. 
The majority of all these cases have been made 
normal or greatly benefited by the fast and 
milk diet, and for this reason I am giving this 
diet procedure preference in consideration. 
The milk diet is the most logical diet to follow 
the fast, and this is also the most logical and 
satisfactory diet for the restoration of muscle 
and nerve tone, normal quality, quantity and 
circulation of the blood, and normal quantity 
and effectiveness of digestive secretions. As 
155 



Constipation 


all of these results must be secured before con¬ 
stipation is permanently corrected, I recom¬ 
mend, therefore, the milk diet for all cases 
where it is at all possible to follow it. 

Owing to a lack of any cellulose or rough 
fibrous material in the residue of milk, with 
sometimes a formation of feces of marble 
smoothness (but not hardness), the rectal 
nerves, which in constipation are less respon¬ 
sive than normal, may not be stimulated suf¬ 
ficiently to create normal evacuation, and the 
diet may apparently be aggravating or at least 
not correcting the intestinal sluggishness. 
But this lack of irritation is exactly what is de¬ 
sired in many cases. Have no fear that the in¬ 
testines are further losing their responsiveness. 
As a convalescent patient gradually recovers 
general strength so are the rectal nerves and 
muscles slowly but surely recovering their lost 
tone and their ability to function normally. 

However, there is so much to the subject of 
the milk diet that it is impossible to incor¬ 
porate complete instructions for its use in this 
volume. For the benefit of those who wish to 
follow it, I may say that usually it may easily 
he followed while one is engaged in his usual 
156 



Treatment 


& 


occupation. Briefly, the points to consider 
are quantity, method of taking, and a correc¬ 
tion of the temporary bowel inactivity while 
the intestinal structures are being gradually 
restored to normal. The purest of milk ob¬ 
tainable should be used—that from any breed 
of cows other than Jersey or Guernsey; it 
should be taken unpasteurized if possible- 
though if pasteurized milk is used the results 
will be satisfactory if the juice of an orange 
or two is taken daily, and possibly a small 
amount of lemon juice taken directly with 
the milk. On an average, men require from 
five to six and a half quarts and women from 
four and a half to five and a half quarts daily. 
The dosage is one glass of eight ounces every 
thirty or forty minutes, for about twelve hours 
daily. A half-pint or at most a pint enema of 
warm or cool water, repeated immediately if 
necessary, will take care of any delayed activ¬ 
ity of the bowels. No other food is taken with 
the milk except the fruit juices mentioned. 
The lemon juice will prove to be almost a 
panacea for all the minor digestive disturb¬ 
ances that may temporarily result from or 
while on the milk diet. 


157 



Constipation 


How long this diet will be required also de¬ 
pends upon the severity of the constipation, 
its duration and effects, and the responsive¬ 
ness of the patient. Some few people will 
require the diet for two or three weeks only; 
others for a period of six to ten weeks; and 
where the colon and rectum have undergone 
extensive dilation and prolapsus or both it 
may be necessary to repeat the fast or fruit 
diet after a period of six weeks or so on the 
milk, with a repetition also of the milk diet for 
a few weeks longer. It is impossible to deter¬ 
mine beforehand just how long will be re¬ 
quired to establish the desired results. Every 
week the milk diet is adding additional tone 
to the digestive structures and bringing the 
patient that much nearer to freedom from in¬ 
testinal stasis and the resulting symptoms and 
conditions. Some patients naturally respond 
to any particular treatment—whether it be 
dietetic, exercise, manipulative, hydrotherapy, 
or what not—much more readily than others. 

Changing from the Milk Diet. After this 
diet has been taken sufficiently long to re¬ 
establish the desired condition of the intestinal 
tract, or until a considerable improvement has 
158 



Treatment 


been made, or as long as convenience will per¬ 
mit, it is extremely important that the diet 
following be so adjusted that the benefit de¬ 
rived from the previous treatment will not be 
undone. Where possible the milk should be 
taken, as during the entire milk diet, during 
the mornings of at least four or five days, 
preferably for two or three weeks, half the 
quantity previously consumed being taken up 
to one or two p. m.; from this time until five 
or six p. m. nothing but an occasional glass of 
water should be consumed. But at the usual 
supper (dinner) time a meal consisting of a 
vegetable soup, fresh vegetables cooked and 
raw, and a slice or two of bread made from 
finely ground whole wheat flour may be taken. 
One or two eggs, not fried, or pot cheese or a 
handful of nutmeats thoroughly masticated 
may be added to the meal if the weight and 
vitality are somewhat below normal. In the 
place of soup a small serving of prunes, apple 
sauce, apricots, peaches, rhubarb, berries or 
melon, or a glass of buttermilk or well-beaten 
clabbered milk (sumik) may be substituted. 

Full Solid Diet. Later, when one desires 
to change completely from the milk, the two or 
159 



Constipation 


three meal plan may be adopted. In either 
case the evening meal should be similar to the 
one suggested above. The morning meal, 
when three meals are taken, may consist of a 
small dish of whole grain cereal, such as thor¬ 
oughly cooked whole grain wheat taken with a 
spoonful of honey or a couple of ounces of 
seeded or seedless raisins or prunes, and a glass 
of any kind of milk desired; or the cereal may 
be omitted and the sweet fruit or milk taken 
with fresh fruit. The noon-day meal may be 
similar to either the breakfast or evening meal 
as desired, or it may be a large raw vegetable 
salad with rye or whole wheat bread and a glass 
of buttermilk or water; or a vegetable salad, 
with sweet fruit or melon and sour milk or 
soup. Olive oil may be used liberally on the 
salad, if desired. In case two meals are taken 
the morning meal may be an entire grain 
cereal with sweet fruit, berries, or melon and 
some form of milk; two, three, or four glasses 
of milk may easily be taken at this meal after 
the milk diet and the increased residue result¬ 
ing from it will be helpful in maintaining nor¬ 
mal bowel evacuation. 

In a considerable number of people a small 
160 



Treatment 


amount of milk seems to have a constipating 
tendency, but the rest treatment and the milk 
diet already prescribed will have corrected this 
tendency; and if some whole grain cereals and 
laxative fruits and vegetables are taken as part 
of the diet the milk should no longer be con¬ 
stipating. 

Whether or not the milk diet is taken for 
your constipation, the rest to the bowels by 
the fast, or by giving them only fruit juices if 
only for a day or two, should initiate the treat¬ 
ment for re-awakening the bowels to normal 
action, though without doubt many cases are 
corrected without this fasting period. I favor 
it for all cases because of more rapid, favor¬ 
able results—as well as because practically 
every one needs such a rest from over-feeding. 

If the milk diet is not used then take a solid 
food diet, being careful in your selection of 
foods and in the quantity consumed, as well as 
in thorough mastication. The meals mentioned 
under the two or three meal plan, with modifi¬ 
cation, may be used when the milk as a strict 
diet is not taken. And these meals may be 
used with safety and benefit in case the fast is 
not taken in any form. 

1G1 



Constipation 


In order to simplify the subject of diet I am 
dividing foods for constipation into two 
classes—those to use and those to avoid: 

FOODS PERMISSIBLE FOODS TO AVOID 


Soups: The vegetable soups 
made from asparagus, celery, 
green peas, green corn, onions, 
spinach, or combinations of 
these; in some cases of beans, 
split pea and tomatoes. 

Meats: Beef especially, 

poultry, sweet breads. Rare¬ 
ly liver, and sea foods other 
than fish to be taken. 

Meat Substitutes: Eggs any 
way but fried, nuts, thorough¬ 
ly masticated, pot cheese. 

Vegetables: Asparagus, 
beans—shell and string— 
beets, cabbage, celery, cresses, 
kale, lettuce, onions, pars¬ 
nips, radishes, spinach, to¬ 
matoes. 

Cereals: Oatmeal, shredded 
wheat, whole wheat (bran 
and all), whole grains of bar¬ 
ley and rye; unpolished rice; 
bran in some cases, usually 
in small amounts. 

B reads: Boston brown, 
whole corn-meal, graham, rye, 
whole wheat; oatmeal crack¬ 
ers also and in some cases 
bran bread and pumpernickle. 

Fats: Butter, cream, olive 
oil. 

Sugars: Honey, brown 
sugar, maple and milk sugars. 


Soups: Fat soups, meat 
broths, bouillon. 


Meats: Pork, immature 

meats, salt, smoked and 
pickled meats and fish; fried 
meats, usually shell food. 

Meat Substitutes : Navy and 
kidney beans, fried .eggs, 
cheese except cottage (pot) 
cheese. 

Vegetables : Navy and kid¬ 
ney beans, and potatoes other 
than baked or boiled in skins; 
squash and turnips in some 
cases. Raw turnips may be 
used. 

Cereals: Refined flour 
products — macaroni, spa¬ 
ghetti, noodles; polished rice, 
tapioca, pearl barley. 


Breads: White flour bread, 
degerminated corn - meal 
breads, white rolls, buns, bis¬ 
cuits, griddle cakes, etc. 

Fat: Meat fats and fat 

meats. 

Sugars: Sirups, molasses, 
jellies. 


162 




Treatment 


Foods Permissible and to Avoid (Continued) 


Fruits: Mildly acid and 
sub-acid fruits, and dates, 
figs, prunes, raisins; canned 
fruits if re-cooked. 

Desserts: Ripe fruits, 
stewed fruits and berries, 
baked apples, occasionally ice 
cream. 


Beverages : Buttermilk, 
cider, diluted fruit juices, es¬ 
pecially grape coffee, honey- 
tea, koumys, lemonade, milk, 
sumik. 

Condiments: Lemon juice, 
pure mayonnaise, some salt. 


Fruits: Fruit jams, pre¬ 
serves, and in most cases mar¬ 
malades and bananas. 

Desserts: Chocolate and 

rich puddings, pastries—cake, 
pie, etc.; bleached sulphur¬ 
ized fruits, confectioneries, 
corn-starch, custards in some 
cases. 

Beverages: Carbonated bev¬ 
erages, chocolate, cocoa, cof¬ 
fee, tea, alcoholic beverages. 


Condiments: Pepper, spices, 
horse radish, mustard, ket¬ 
chup, condiments, pickles of 
all kinds including piccalilli, 
chow-chow, etc. 


In general avoid rich concoctions; highly sea¬ 
soned dishes; those requiring long preparation; 
large varieties; mushy, pasty foods; and con¬ 
centrated foods—those from which the fibrous 
elements have been removed. When meats are 
taken they should be cooked rare, but in most 
cases it is better not to use meat. 

The Uncooked Diet. If the various cooked 
foods and combinations thus far described are 
tried without benefit, especially when some of 
the other factors of treatment are used, then 
it may be advisable to adopt a diet that to the 
average individual will appear rather unusual. 

163 



Constipation 


For such cases I would advise the use of un¬ 
cooked foods. 

Uncooked or natural foods are capable of 
producing greater vitality because of the more 
abundant vital food elements they contain. 
They have more satisfying flavors and stimu¬ 
late the flow of digestive secretions more than 
do most other foods that are prepared without 
stimulating spices and condiments. They also 
require more thorough mastication. The di¬ 
gestion is therefore benefited in several ways, 
and the bowel activity will be more nearly nor¬ 
mal. These results are in addition to the effect 
of the natural stimulating cellulose of the un¬ 
cooked foods. 

A small cup half or two-thirds full of raw 
rolled oat or wheat flakes, with a small amount 
of sweet fruit and possibly nuts, moistened 
slightly with milk is a markedly nourishing 
dish, and at the same time is a normal stimu¬ 
lant to the intestinal tract. If one has a dis¬ 
taste for the strictly raw cereals used in this 
manner it is very probable that the taste may 
be cultivated, or one might take one cupful of 
the flaked cereal preferred, add to it a similar 
quantity of water, then bring it to the boiling 
164 



Treatment 


point. As soon as this heat has been secured 
the food is ready to serve, and can be eaten 
with any sweet fruit desired and with cream 
or milk as suggested above. 

The whole grains of wheat, oats, barley and 
rye may be used in this manner. Or they may 
be soaked overnight in a small quantity of cold 
water; in the morning place on the stove and 
let them simmer gradually for several hours 
or until the grain is soft. Do not add so much 
water that any part of it must be poured off 
the grain. Fifteen minutes or half an hour 
before taking the grain from the stove add the 
desired sweet fruit. Many recommend that 
the grain be eaten without any liquid, though 
when thus taken even more thorough mastica¬ 
tion is required. It is usually better to have 
these grains lightly moistened. 

I would advise that as nearly as possible 
these special dishes make up the entire meal, 
with the exception of one juicy fruit such as 
an apple, pear or peach, or even an orange. 
As a rule one of these dishes may be eaten to 
the extent of one’s desires without harm, if it 
constitutes the entire meal; and if a really 
serious case of constipation exists it is fre- 
165 



Constipation 


quently necessary that one eat a fairly large 
quantity of the form of food desired. But one 
meal a day of these foods would be sufficient, 
as they are rather pronounced in their stimu¬ 
lating effect. For the other meal or two sim¬ 
ple combinations of uncooked foods may be 
used, without special attention to their laxative 
qualities. 

As already mentioned, there are many 
other articles of food which can be added to an 
uncooked diet. The vegetables and fruits 
which can be eaten raw are in large numbers 
and these are extremely useful. 

In regard to foods and their effect upon the 
digestive canal it may be said that, as a rule, 
those foods easiest of digestion and assimila¬ 
tion tend to constipation while those less easily 
or less completely digested and assimilated 
have a greater tendency to prevent or relieve 
this condition. An ouer-use of laxative foods 
may eventually produce constipation; but they 
may also be a source of considerable economic 
loss, as during the period of the body reaction 
to them they are inclined to carry from the in¬ 
testinal tract considerable nutritive material. 
This is due to the incorporation of these gen- 
166 



Treatment 


eral food elements with the cellulose or woody 
fiber which is undigested, as much as to the 
fairly hasty evacuation of waste following 
consumption of such excessively laxative sub¬ 
stances. 

Meat. I do not believe that it is necessary 
for the formerly heavy consumer of meat, or 
for most others for that matter, to abstain en¬ 
tirely from meat as an article of diet. But 
the average person uses it in such large quanti¬ 
ties and with such great variety of other foods 
that it undergoes putrefaction, which helps to 
create fermentation of other food. Besides, it 
has a very low stimulating power upon the 
intestines. For these reasons it is best that 
only a small amount of meat be taken, espe¬ 
cially when attempting to correct constipation, 
or that it be eliminated entirely from the diet 
until the bowel actions have approached nor¬ 
mal. When taken it should not be fried, and 
I am convinced that immature meats should 
be avoided. Whenever meat is a part of the 
meal the main bulk of that meal should he 
leafy vegetables or a considerable quantity of 
berries or melon, with from one to three glasses 
of fairly hot water. White bread, potatoes, 
167 



Constipation 


rice, macaroni, pastries, spices, tea and coffee 
should form no part of a meal in which meat 
is used; and some of these, of course, should 
be rigidly excluded from all meals, most par¬ 
ticularly by those subject to constipation. 

Gems and Muffins. As the average indi¬ 
vidual is more or less “lost” without some bread 
or bread substitute and, as bran and whole 
wheat are effective laxatives, a satisfactory 
bread, gem, or muffin will be a good addition 
to one’s diet. The following recipes are given 
for the benefit of those desiring them: 

Whole Wheat Gems. 

1 quart whole wheat flour 
1 quart water . 

1 tablespoonful melted butter 

2 tablespoonfuls sugar 

2 tablespoonfuls baking powder 
A pinch of salt 

Beat thoroughly and put into hot greased 
gem pans; bake twenty minutes in hot oven. 

Whole Wheat Muffins. 

iy 2 cups whole wheat flour 
1 teaspoonful pure olive oil 
1 tablespoonfui honey or sugar 
1 egg 
1 cup milk 

1 teaspoonful baking powder 
1 saltspoonful salt 

Beat the olive oil, honey or sugar, and egg 
168 



Treatment 


together, then add the cup of milk; mix well 
the flour, baking powder, and salt, then mix 
all together; bake in muffin pans in a hot oven 
for twenty minutes. This portion will make 
twelve muffins. 


Bran Gems No. 1 . 

2 cups wheat bran 
1 cup bran meal 
1 cup milk 
y 2 cup hot water 
% cup molasses 
y 2 teaspoonful soda 
1 tablespoonful butter 
Salt to taste 

Dissolve the soda in the hot water; then add 
the molasses, butter, salt, milk, bran and meal; 
mix thoroughly; put in well greased gem pans 
and bake forty-five minutes in medium slow 
oven. 


Bran Gems No. 2. 

2 cups bran 
1 cup Graham flour 
1 cup milk 

y 2 cup honey or dissolved brown sugar 
y 2 teaspoonful baking soda, dissolved in hot water 
1 teaspoonful butter 
Salt to taste 

Mix thoroughly; put in well-buttered gem 
pans and bake for forty-five minutes in me¬ 
dium slow oven. 


169 



Constipation 


Bran-fruit Wafers. 

1 pound dates, raisins, prunes or figs, or a pound of 
any two of these 
Bran, a pint to a quart 
1 pint of water 

y 3 cup of honey—strained or comb honey. 

Soak the fruit over night in the water, press 
the pulp into the water, then strain; add the 
honey and thoroughly mix; add to this water 
all the bran that can be lightly moistened by 
it; roll the moistened bran to one-quarter inch 
thick on buttered paper in large bread pans; 
press bread knife or other steel lengthwise and 
crossways into the bran so as to form squares 
or oblong sections; place pans on back of stove 
or in a very slow oven where the bran will dry 
but not bake; when thoroughly dry break into 
sections and store in dry place. 

If desired, the ground pulp of the prunes 
or dates may be added to the bran. 

Orange Peel. Orange peel may be pre¬ 
pared in such a manner as to be beneficial to 
those afflicted with constipation. The peel 
should be boiled in water for thirty minutes or 
so to release the oil, which is more or less irri¬ 
tating to the digestive tract; the water is then 
discarded and the rinds sweetened if desired. 
This gives a clean indigestible mass of cellu- 

170 



Treatment 


lose upon which the digestive apparatus may 
work. 

Grapes and Berries. The French say of 
the grape that “it not only dilutes thick blood 
but sends the circulation to the surface, giving 
color to the pale cheek; it removes obstructions 
from the liver and lungs, aids digestion, brings 
the stomach and bowels into a healthy state, 
dislodges gravel and calculi from the kidneys, 
and confers vigor and health upon the pros¬ 
trate system.” It is certain that the grape is 
a valuable fruit, in health and disease, and 
should be used freely, when in season. 

In constipation the entire grape should be 
taken; however, as the skin contains a slightly 
astringent juice, it may be necessary for some 
few people to discard this part of the fruit. 
Only when there is stomach or intestinal irri¬ 
tation or inflammation need the seeds be ex¬ 
pelled. From one to three pounds of grapes 
may be taken daily, but not with a meal or 
other foods; the grapes should constitute a 
meal or two of the day by themselves, or as 
part of a simple combination with nuts or 
sweet fruits only. 

Grape juice alone is often an effective intes- 
171 



Constipation 


tinal activator. This is especially so if it is 
taken in the form of what some call grape 
coffee. This is made by filling a cup about 
one-third full of grape juice, sweetening it with 
a teaspoonful of sugar or honey, and filling 
the cup with hot water. If one or two cups 
of this are taken immediately after a meal 
(that contains little starch), the action of the 
bowels is usually greatly stimulated. 

Blackberries, raspberries, strawberries and 
currants, in fact practically all berries with the 
exception of gooseberries, are laxative in na¬ 
ture and should be used freely, in season. But 
these should not be covered with sugar; they 
should be taken “straight,” or with a small 
amount of brown sugar, and alone, or with 
some fruit, nuts, or a small amount of whole 
grain cereals. 

Yeast. Baker’s yeast, while not classed as 
a strict article of food, may be taken with con¬ 
siderable benefit in some cases, as it seems to 
alter the “intestinal flora” favorably. It has 
been found of greatest benefit in those obsti¬ 
nate cases which ordinary treatment has not 
favorably affected. It has none of the irri¬ 
tating laxative properties of cathartics and yet 
172 



Treatment 


frequently aids in producing natural and regu¬ 
lar elimination of waste. Both dried brewer’s 
yeast and the ordinary compressed yeast are 
used. It is of some value in troubles of the 
digestive canal, especially catarrh of this canal, 
whether the catarrh be the cause or the result 
of constipation. It is not to he used in acute 
digestive disorders. 

In taking this product small pieces may be 
broken from a fresh cake and taken plain. By 
this plan a liking for the yeast may be devel¬ 
oped, as it is somewhat like cream cheese. 
Some prefer the addition of a small amount 
of salt. Fresh yeast may be mixed with a 
little butter and spread on fresh hot toast or 
toasted crackers, or it may be dissolved in 
water or malted milk or in fruit juices. If it 
is allowed to stand for a few moments sub¬ 
merged in the preferred liquid, it may be com¬ 
pletely dissolved by a little stirring. If it has 
a tendency to produce gas, as it may do in a 
few cases, dissolving it in a half cup of hot or 
boiling water will destroy the fermenting 
power and yet retain the beneficial properties ‘ r 
but it is less inclined to produce gas if taken 
before meals on an empty stomach. As yeast 
173 



Constipation 


is not a medicine, there is no danger of an 
“over-dose,” as we usually understand this 
term in regard to drugs. If the small cakes 
are used, from one to three may be taken daily; 
other preparations in similar or smaller quanti¬ 
ties. Children usually may be given half the 
quantity used by adults. 

While much of a favorable nature has been 
written on the subject of yeast, I believe that 
if the diet and mode of life in general approach 
normal this product will not be required. 

SAMPLE MENUS 

In summing up the dietetic treatment, I 
give here a sample diet schedule for the day 
for the average case of constipation. In milder 
and more severe cases the schedule will need 
to be altered to fit the individual case. 

On rising: One to two glasses of water, 
preferably cold (not iced), or one orange, one 
apple, or one pear, or the water and the fruit 
or a glass of dilute fruit juice. 

Breakfast, (twenty or thirty minutes 
later) : A dry ready-prepared cereal with a 
small amount of either sweet fruit such as 
dates, raisins, prunes or figs, or of dried 
174 



Treatment 


peaches or apricots or apple sauce. A dry- 
cooked cereal may be used, especially entire 
wheat grains or oatmeal. On the prepared 
cereals use cream or rich milk in small 
amounts, but if cooked cereals are preferred it 
is better to have them dry—without additional 
moistening. One or two glasses of milk may 
be taken slowly, or grape coffee or cereal cof¬ 
fee with honey instead of sugar may be used. 

The cereal may be omitted and acid fruit 
taken in its stead; or milk and acid fruit, or 
milk and sweet fruit alone may be taken; 
fruits to use are the sweet fruits mentioned and 
oranges, grapefruit, peaches, pears, apples, 
plums, or berries. In some cases the mixture 
of one quart of hot water, the juice of one 
lemon and a half teaspoonful of salt may con¬ 
stitute the entire breakfast, or may be used 
immediately upon arising, with breakfast an 
hour or more later. 

The breakfast outlined may constitute the 
first of two or three meals, according to the 
plan selected, which may be determined to a 
considerable extent by the occupation and 
general condition of nourishment and vitality 
of the patient. 


175 



Constipation 


Mid-forenoon: One or two glasses of 
naturally cold water—preferably two glasses. 
Avoid ice water. 

Dinner: Vegetable soup; two vegetables— 
one to be green; vegetable salad with olive oil; 
muffins of bran or whole wheat, or bran 
wafers, with butter; sweet or dried fruits, 
cereal or grape coffee or buttermilk. One or 
more of the laxative foods may be omitted. 
This meal may be the large meal of the day. 

Mid-afternoon: One or two glasses of 
naturally cold water. 

Supper: For the third meal, taken at least 
three hours before retiring, have a green vege¬ 
table salad composed of leafy vegetables, with 
one or more finely chopped or grated tuberous 
vegetables if desired. I give these combina¬ 
tions as suggestions: lettuce, tomatoes and 
onions; lettuce, tomatoes and celery, or aspa¬ 
ragus; lettuce, tomatoes, celery, onions, and 
cucumbers. Grated carrots may replace any 
vegetable or be added to any combination 
given; carrots and lettuce alone; carrots and 
raw cabbage; or apples and celery: either of 
these, with or without chopped nuts, will form 
a satisfactory salad. Olive oil and a small 
176 



Treatment 


amount of lemon juice, or mayonnaise may be 
used as dressing. 

With the salad may be taken the heavy por¬ 
tion of the diet, whether it be a small amount 
of meat, fish, eggs, nuts or legumes. Omit the 
nuts on the salad when protein is taken as a 
separate dish. Whole wheat bread or gems, 
muffins or wafers may be taken, though it 
would be well to have this meal simple in com¬ 
bination, as mentioned under “Meat,” page 
167. A vegetable soup may begin the meal, or 
a cereal coffee be taken at the end of the meal; 
or in case meat is not included, a glass of but¬ 
termilk or sumik may be taken at the comple¬ 
tion of the meal. 

Before retiring: A glass of water, an 
apple, an orange, prunes, dried figs or one or 
two wafers with half a glass or a glass of water, 
may be taken in stubborn cases; but do not 
have fruit at this time and also upon arising. 
As mentioned earlier, hot water alone, when 
taken at night, is a good aid in bringing about 
normal morning evacuations. 

Substitutions may be made if any article 
given is not procurable. If any particular 
article of food has been found to disagree in 
177 



Constipation 


any way do not take it merely because it is 
good for the average individual or helpful in 
the average case of constipation. 

When normal bowel action has become well 
established, omit the most markedly laxative 
article from one meal, then from each meal 
when possible without losing the improvement 
secured. As frequently stated, too much 
cellulose steadily used will in time aggravate 
the condition for which it is taken; but the 
diet should never be totally devoid of this in¬ 
digestible material. 

It will be noticed that menu variation is con¬ 
siderable, since the fruits and vegetables 
selected may be changed to suit taste, require¬ 
ments, and necessity. The diet will vary 
necessarily with different individuals. Noth¬ 
ing has been omitted from the diet that is of 
value in maintaining full nourishment and 
complete strength and health. Pastries, 
sweets and rich desserts, appetizers, etc., are 
purposely excluded, as they have no place in 
a remedial diet, nor, in fact, in any diet. 

INTESTINAL ACTIVATORS OTHER THAN 
FOODS 

Mineral Oil. In many cases of constipa- 
178 



Treatment 


tion, especially of the spastic and the dry colon 
types, mineral oil has been found to be a con¬ 
siderable relief. There are numerous mineral 
oils on the market, each sold under a specific 
trade name. But Liquid Petroleum is the 
name selected by the U. S. Pharmacopeia to 
designate particularly mineral oil, other names 
being liquid paraffin, paraffin oil, Russian oil, 
Russian mineral oil, etc. For constipation 
these oils have an advantage over oils of vege¬ 
table and animal origin in that they are not 
digested and absorbed. They perform no 
function within the physical economy other 
than lubrication of the walls of the alimentary 
tract. Dr. W. Arbuthnot Lane, the great 
English surgeon, highly endorses liquid petro¬ 
leum for use in all cases of constipation. He 
recommends the regular use of the oil to per¬ 
sons in health, and particularly if there is a 
tendency to constipation. He prescribes and 
recommends a dessertspoonful every night be¬ 
fore retiring. As the oil is not laxative or 
purgative it does not quickly excite action to 
the bowels as do some drugs; it simply lubri¬ 
cates the intestinal walls, and, as several days 
may elapse before the oil takes effect, its use 
179 



Constipation 


must therefore be continued. It will be value¬ 
less if used haphazardly; if it is used at all it 
should be taken regularly and continuously, 
at least until its use is no longer required. 

On the other hand, there are some physicians 
who question the value of mineral oil, holding 
that it is a foreign substance, that it does not 
always agree with one and sometimes causes 
the formation of gas. My own opinion coin¬ 
cides with this and is also that the oil is inclined 
to coat the particles of food in the intestines 
and thus prevent their complete digestion by 
the digestive juices. Also it does work for the 
intestines that these should be made to do nor¬ 
mally without assistance. Yet great numbers 
of persons declare that it has offered them the 
solution of their constipation problem. It is 
certain that it will prevent stagnation of the 
bowel contents and in this way it hinders de¬ 
composition. It is decidedly less injurious 
than drug laxatives and cathartics that secure 
their action through irritation, but it should be 
necessary only with those individuals who will 
not readjust their dietetic and other habits. 

Agar-agar. Agar-agar, or Japanese Sea¬ 
weed, is now used quite extensively, either 
180 



Treatment 


alone or mixed with the diet, as a simple me¬ 
chanical means of correcting constipation. 
This material is somewhat like bran in appear¬ 
ance, but its effect is secured through its 
ability to absorb and hold in its porous cellu¬ 
lose structure large amounts of moisture. Its 
stimulating effect upon the nerve ganglia and 
upon the intestinal mucous membrane is very 
slight, so that its use is not inclined to over¬ 
stimulate these nerves greatly and thus 
aggravate a constipation tendency. A table¬ 
spoonful or more may be taken with a little 
water or the material may be added to the 
cereal or to any other dish of the meal. Some 
companies combine the agar-agar with the 
mineral oil, making an emulsion that combines 
the effects of these substances. If no laxative 
drugs are combined in this emulsion it may be 
used temporarily in some more or less stub¬ 
born cases. 

Bear in mind, however, that these are not 
curative any more than is liquid petroleum. A 
measure that is truly curative is one that is not 
perpetually and continuously required—one 
which will continue its good effects even though 
for any reason temporarily discontinued. In 
181 




Constipation 


order to cleanse once thoroughly the intestinal 
tract the liquid petroleum or agar-agar may 
be used by those who are more satisfied when 
“taking something”; but the use of either 
should not become a mental habit; they should 
be dispensed with as soon as possible. It seems 
scarcely rational to demand perpetually of the 
digestive system that it receive, manipulate, 
and pass on some article or substance from 
which the rest of the physical organism receives 
no benefit whatever in the way of food ele¬ 
ments. 

HARMFUL AGENTS 

Mineral Waters. There are some agents 
used to bring about intestinal activity which, 
to the deluded individual, appear to be cor¬ 
rective; for instance, mineral waters. People 
will take these for years, changing from one to 
another when the effect of the one is reduced, 
as will be the case with all of them; for they 
are merely drug compositions, even though 
coming direct from the earth. Nature has 
placed certain minerals and mineral salts in 
various parts of the earth and the water in cer¬ 
tain underground veins, in coming in contact 



Treatment 


with these substances, dissolves them and takes 
them up in solution. It is these salts which 
produce the laxative effects. But the salts are 
inorganic and the mineral waters containing 
them are as truly drug-laxative as are Epsom 
salts, Rochelle salts, etc. 

There are certain other mineral waters 
which are not laxative in themselves though 
fairly heavily laden with mineral substance. 
Their effects upon the intestines are due 
merely to the consumption of large quantities 
of them by the individual who believes that the 
waters themselves have some corrective or 
remedial qualities. Frequently these are taken 
in the otherwise wholesome environment of a 
social watering spa, where physical activity is 
inclined to be somewhat greater than usual. 
The several glasses of water consumed daily, 
together with a greater activity, and cheerful, 
pleasing environment, etc., are responsible for 
the happy results; but these results are tem¬ 
porary if there has been no change in one’s 
mode of living that will be persisted in after 
discontinuance of the water-drinking. 

Tobacco. Many men are deluded into be¬ 
lieving that they, have found an efficient pre- 
183 



Constipation 


ventive of or relief from constipation in 
tobacco-smoking, possibly tobacco-chewing. 
A considerable number find that a cigar or 
pipe, or possibly a cigarette or “chew 55 of 
tobacco, shortly after a meal, especially after 
breakfast, will bring about a desired bowel 
evacuation. Tobacco may produce this effect, 
but it will not continue to do so indefinitely. 
The results are secured through the efforts of 
Nature to remove an unnatural irritating sub¬ 
stance from the body. In other words, the 
effect is produced in the same way that many 
other drugs secure their effect: by excitation 
and stimulation of the nerves to remove from 
the system that which has only a detrimental 
effect; for tobacco is a drug, its continued use 
being possible only through “toleration” of the 
body for it. 

Harmful Laxative Foods. With some 
people coffee will have a laxative effect; and 
with other people certain articles of food which 
are not strictly wholesome foods, among which 
may be mentioned pancakes or flapjacks, sauer 
kraut, chilli con carni, beer, etc., will have 
a similar effect. The effects secured by the 
use of these articles of so-called food will 


184 



Treatment 


usually be brought about by marked stimula¬ 
tion and by an effort of the system to remove 
that which may be harmful, also possibly by 
fermentation, resulting in loose stools. 

As a rule we may consider any substance 
which, when taken into the digestive tract, pro¬ 
duces a fairly quick laxative action to be irri¬ 
tant, securing its effects mainly through the 
efforts of the body to expel it. However, there 
are certain wholesome foods which have this 
fairly quick action in certain individuals, and 
their use in these cases will very probably be 
beneficial rather than otherwise. Especially 
will this hastened action be normal and harm¬ 
less when produced by such recognized bene¬ 
ficial and natural foods as the fresh fruits and 
vegetables. 

But even certain of these in a very few cases 
are directly irritant because of the degree of 
idiosyncrasy or susceptibility of the person. 
Except in an emergency one should not 
habitually take into the mouth and stomach 
anything which empties the bowels quickly. 
Whenever this sudden action occurs there will 
be a reverse action, or reaction, with lessened 
speed of physiological processes, that is very 
185 



Constipation 


apt to bring on, perpetuate, or aggravate con¬ 
stipation. 


EXERCISE 

Next in importance to diet and early re¬ 
sponse to the calls of Nature is exercise. While 
the muscles of the intestinal tract, except for 
the very outlet gates, are wholly involuntary 
and beyond the control of the will, their tone 
depends to a considerable extent, as we have 
seen, upon the tone of the external muscles. 
In addition to this, the tone of the internal 
muscles depends upon normal quality, quan¬ 
tity and circulation of the blood, which cannot 
be secured in a body denied sufficient action of 
the skeletal muscles. Furthermore, exercise 
of the proper kind produces a massage effect 
upon the inner abdominal organs and the in¬ 
testines. Not only are the muscles surround¬ 
ing the abdomen brought into play promi¬ 
nently, but the diaphragm, which presses 
downward upon the intestines, is made to take 
greater excursions into the abdomen at each 
breath, and its action is more rapid and more 
vigorous where exercise of such nature is taken 
as to quicken and deepen the respiration. 

186 



Treatment 


In the adoption of a system of exercise to 
be used in connection with other means for 
the correction of intestinal stasis, it is neces¬ 
sary that one select exercises within his 
strength; the system should be general while 
at the same time directly corrective; it should 
be pleasureable and one that can be adhered to 
at least until results are secured; in fact it 
should become a part of the permanent daily 
schedule. One should not expect to find one or 
more exercises that call into use just the 
muscles necessary to strengthen, tone up, and 
naturally stimulate the bowels. Even if such 
an exercise could be found it would not be 
sufficient. Entire body tone must be main¬ 
tained, but at the same time exercises that have 
a more pronounced effect upon the muscles 
surrounding the organs of digestion should be 
included in the system of exercise adopted. 

Walking. There are exercises that do not 
involve, except to a slight degree, the abdo¬ 
minal organs, which still are extremely valu¬ 
able in the correction of constipation. Their 
results are secured partly through the increase 
in the action of the diaphragm but also partly 
by their vibrating effect upon the entire body 
187 



Constipation 


and the stimulation of the circulation and of 
general metabolic processes. Chief among 
these exercises is walking. The rhythmic ele¬ 
vation and lowering of the body has the effect 
of mildly shaking up the intestines and their 
contents, helping gas to escape and the solid 
contents to move out of the kinks and pockets 
and gradually downward toward and into the 
rectum. The more rapid the walking, up to 
three and a half or four miles an hour, the 
greater will be the direct effect in the average 
case. Lazy strolling will not produce the de¬ 
sired results in the average individual but may 
be effective in those who have previously de¬ 
nied themselves all forms of exercise. If 
possible one should devote at least an hour a 
day to exercise, and if five to eight or ten miles 
a day can be covered by walking the general 
functional activity will be greatly increased. 
The length of the walk, also the length of the 
stride and the speed, will depend largely upon 
the individual’s condition. It is the mild stim¬ 
ulation of long-continued exercise which many 
cases of constipation require, and this is pro¬ 
vided by walking. In walking one should 
sway the body and secure a slight body rota- 



Tkeatment 


tion at each stride; also the hip of the advanc¬ 
ing leg should be moved forward as the 
opposite shoulder rotates forward, in order 
that the muscles of the trunk may be brought 
into action to an appreciable extent. 

Running. Running produces the effect of 
walking, only more quickly and to a more 
decided extent. It is not possible for some 
people, but those who have no contra-indica¬ 
tion to it would find all physical troubles 
greatly reduced if they would take at least a 
short run daily or frequently. The alternate 
walk and short run is perhaps the best com¬ 
bination of exercises for a single effect. When 
running out of doors or on an indoor track or 
floor is impossible, the standing run may be 
taken in any room provided with sufficient 
circulation of air. In fact, the standing run 
is sometimes more effective because in this ex¬ 
ercise one may bring the knees up to the chest 
at each step, thus securing direct compression 
upon the abdomen and its contents, as well as 
a more decided vibration and internal massage. 

Rope-skipping. Rope-skipping is one of 
the most valuable forms of exercise to stimu¬ 
late the intestines as well as to benefit heart. 


189 



Constipation 


lungs, and other vital organs. The move¬ 
ments of the arms add somewhat to the benefit 
of the exercise. One should begin with a small 
amount of this exercise (also of the standing 
run) and gradually increase in speed and 
duration as the heart and lungs respond. 
Avoid the jar of landing on the heels when 
taking these exercises. Those who have hernia 
or more than a slight degree of prolapsus of 
abdominal or pelvic organs should not attempt 
these exercises until, by other means, there has 
been a reduction of the structural defect. The 
same precautions will not hold, however, for 
one with varicocele; these exercises and also 
walking and outdoor running are among the 
best for the reduction of varicocele, at least of 
its uncomfortable sensations. 

Jumping. Another especially valuable ex¬ 
ercise is that of jumping slightly, just as one 
would when jumping a rope. The light jar 
of this particular exercise accelerates the 
activities of the functional organs and will be 
found very valuable as a means of arousing 
intestinal activity. As a rule it is a good plan 
to take this exercise upon arising, and it will 
be found more effective if one takes one or two 


190 



Treatment 


glasses of water before beginning the exer¬ 
cise; the water may be hot or natural cold. 
The exercise should be continued on each occa¬ 
sion until a slight feeling of fatigue is noticed. 
At first, unless one is fairly strong, it may be 
found difficult to jump more than from fifty 
to one hundred times without feeling fatigued, 
though ordinarily the exercise should be con¬ 
tinued from one hundred to three hundred 
times, resting when feeling especially tired. 
However, the same precautions given under 
rope-skipping should be observed here. The 
combination of the stationary run and jump¬ 
ing is perhaps even more satisfactory than the 
jumping alone. 

Sports. All outdoor sports will be of value, 
but among the most helpful are rowing and 
horse-back riding. Rowing provides good 
abdominal massage, also excellent strengthen¬ 
ing and stimulating back exercise, beneficial 
in constipation. Some wise physician said 
many years ago that “the best thing for the 
inside of a man is the outside of a horse.” It 
is probably not the best thing but it is very 
beneficial, particularly where the liver needs 
stirring into greater activity. Riding should 
191 



Constipation 


not be taken to the exclusion of other exercise, 
however. Tennis, volley ball, handball, 
squash, swimming, and such sports which call 
for occasional rapid motion, together with 
body flexions and activity of the large muscles, 
should be of extreme value in any system of 
exercise, where one is not prevented by some 
condition from indulging in them. The dosage 
must be regulated and should not exceed one’s 
vigor. Hunting, fishing, especially game, 
fresh-water fishing, and cross-country tramp¬ 
ing are especially commendable, since they 
bring in the valuable features of walking and 
with a desirable freedom from the probability 
of self-concentration. 

The question is frequently asked if bicycle 
riding is equal in value to walking, horse-back 
riding, or certain other sports. I say emphati¬ 
cally, No! It brings into action mainly the 
thigh muscles and those of the hips and lower 
back; the position of the trunk is not only 
fairly rigid but inclined forward to such an 
extent that the abdomen is compressed and 
the ribs are cramped, so that diaphragm mo¬ 
tions are deficient on account of the improper 
breathing. It is not so detrimental when the 
192 



Treatment 


position is upright, and may really be com¬ 
mended when one combines it with walking 
and running beside the wheel. 

Special Exercises. There are certain 
movements that may be taken which have a 
direct mechanical effect upon the alimentary 
canal, and which will have a marked inclina¬ 
tion to assist the general exercise in remedying 
intestinal sluggishness. Among these exer¬ 
cises are several which have been illustrated 
especially for this book. They will not be 
enumerated in text form. Any one can prob¬ 
ably devise his own system of special exercise 
that will prove quite effective. These special 
exercises should not be relied upon entirely. 
The physical activity must he general, as well 
as local and specific. 

It may be repeated here that the various 
movements that tend to strengthen the 
muscles of the abdominal region give marked 
additional vigor to the internal organs. One 
should realize the importance of strengthening 
the natural abdominal corset—for the direct 
stimulating effect of the exercises to the in¬ 
ternal organs, but equally for holding these 
organs in proper position to function normally. 

193 




Standing erect, hands on hips; raise one knee as high as 
possible as shown; lower while exhaling and inhale and 
repeat, or alternate right and left. Continue for ten to 
twenty times with each leg. 


194 





Raise right knee, clasp it with locked hands and press thigh 
into abodmen. Lower and repeat; alternate. The move¬ 
ment is made more effective by giving an additional pressure 
after reaching the limit of motion of thigh against abdomen. 


195 






Standing erect, hands on hips; bend the trunk forward as 
tar as possible but keep the head up and shoulders back, 
exhaling at the same time; raise while inhaling, and repeat 
ten to twenty times. 


196 






Standing erect, arms at the sides; bring arms quickly to 
a horizontal position and bend far to right as shown with¬ 
out rotating the trunk on the hips, inhaling while bending; 
come to the vertical and drop the hands, exhaling; repeat 
to the opposite side; eight to ten counts to each side. 


197 







Standing erect, hands on hips, charge or lunge far forward 
with the right foot to position shown, taking a deep breath; 
bend the forward knee to about right angles, but keep the 
rear leg straight; then, while holding the lunge position, 
continue as illustrated on next page. 


198 






199 



Continuing from exercise on preceding page, exhale and bend over the right knee and reach 
as far forward with the fingers on the floor as possible. Resume position as taken on the 
lunge, then recover charge (feet together); alternate right and left five to eight counts. 











200 


Standing erect, hands on hips, lunge far directly to the right to position shown, taking a deep 
breath; then, holding lunge position, bend over to right, extending hands as far to right as 
possible, similar to immediately preceding movement. Alternate sides. 







201 


Standing erect, hands on hips; exhale and raise the left leg backward while leaning trunk forward, 
attempting to bring trunk and raised leg to horizontal. Do slowly. Lower leg and come to 

erect position while inhaling; raise right leg in the same manner. 







202 


Standing erect, hands on hips; exhale and raise left leg out to the side and upward while 
bending the trunk far to the right—slowly. Lower leg and come to erect position while 

inhaling. Raise right leg in same manner while bending left. 










203 


Standing erect, hands on hips; inhale and raise left leg high upward to the front while bending 
well backward—slowly. Lower leg and come to erect position while exhaling. Raise the right 

leg in same manner. 








A very effective “muscle control” movement that will be 
good in constipation if mastered. Stand erect, feet slightly 
apart; exhale, bending slightly forward; draw the abdomen 
well in, then contract the central vertical muscles of the 
abdomen by quickly flexing forward slightly more; relax 
and repeat several times. 


204 






Stand erect, the abdomen natural; then quickly draw in 
the abdomen as far as possible and then shift the point 
of greatest contraction from below upward and from above 
downward, in a “muscle rolling” movement. This is diffi¬ 
cult to illustrate and to learn, but very effective. 


205 











Standing, exhale all the air possible from the lungs; hold 
this position (about five seconds) while rapidly forcing the 
abdominal walls in and out. Perform the same movement 
after a deep breath has been taken and held. 






Standing erect, fingers clasped behind head but relaxed; 
bring elbows well back, contracting all spinal muscles while 
at the same time bringing the head slightly backward, 
resisting this motion with hands, to position illustrated; 
inhale while bringing shoulders and head back; relax, 
exhale, and repeat. 


207 






Standing erect, hands on hips; slowly lower body by bend¬ 
ing knees until the hips rest on raised heels, as illustrated; 
have the knees slightly apart and keep the body vertical; 
raise the body while inhaling, and repeat five to eight 
times, exhaling on the squat. 


208 





Stand with feet slightly apart, arms extended overhead, 
body erect or slightly backward with spine well arched 
and head well up and back, as shown. (See next 
illustration.) 


209 






First move is bending far downward, doubling the body 
forward as far as possible, the hands between the thighs, 
knees only slightly bent; keep the arms straight; then raise 
to the upright position, as in previous illustration. (See 
next illustration.) 


210 








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211 











Standing with feet apart, arms out to the sides, squat and 
bring left hand midway between feet while raising right 
hand, watching this hand as illustrated; exhale during squat; 
raise with arms out and inhale; repeat by reversing posi¬ 
tion of the hands and continue alternating four to eight 
counts each way. 


212 







Stand erect, feet apart, hands at sides; bend backward, 
| bringing arms to position shown, while inhaling; then bend 
! forward, arching back as much as possible, and bring the 
hands far back between the legs while exhaling; continue 
backward and forward, bending ten to fifteen times each way. 


213 








Standing, feet slightly apart, palms about lower ribs, fingers 
forward, thumbs to rear. Secure a comfortable grasp with 
edge and palm surface of fore-finger and thumb, giving 
gentle pressure only. (See next illustration.) 


214 







Bend diagonally forward to the right, pressing into the 
abdomen against the liver with the right hand; go far 
forward and downward; in rising to the erect, suddenly 
release pressure of the right hand. Alternate in bending 
diagonally toward the left. 


215 





This is walking on all fours. After a few minutes of this 
exercise drop to position shown below. 




Keep the knees well under the chest, the thighs pressing 
into the abodmen, the hips lower than shown in illustration. 


216 















Stand erect, feet apart, hands at sides; stretch the left arm 
far to right over right foot, the right arm far to rear as 
shown; then reverse, extending right hand over left foot, 
left arm backward; repeat five to ten times to each side. Ex¬ 
hale while rotating to side and inhale when turning to front. 


217 






Place right hand on the soft part of the abdomen, immedi¬ 
ately below the lower ribs and, while exhaling, exert fairly 
deep pressure here; relax and inhale, and repeat several 
times; then do the same on the left side, using the left 
hand as before the right was used. 






218 












Hold arms folded lightly over the abdomen immediately 
below the ribs, as shown; exhale and exert pressure with 
the forearms; relax and inhale, and repeat; the body may 
be bent slightly forward if care is taken not to contract 
the abdominal muscles. 


219 




220 


Lying on back, legs extended, hands behind head; raise left knee, making the knee movement 
fairly rapidly and bringing knee far upward; lower, and repeat; then with right knee, or alter¬ 
nate left and right. Relax fully and repeat. Exhale when raising knee, inhale when lowering it. 





















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222 


Lying on back, legs extended, hands behind head or at sides; raise left leg, keeping the knee 
straight and exhale; lower while inhaling and repeat ten to fifteen times; then with right 
e g, or alternate right and left. Relax, then raise both legs together five to eight times. 
















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223 


without aid of the elbows; lower, inhale, and repeat. 













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224 * 


















Lying on back, feet extended, grasp head of bed to keep trunk in back-reclining position; extend 
left leg far across to right side while exhaling; return to position while inhaling and repeat ten, 

times; then extend right leg to left, or alternate left and right. 

















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226 











227 


Lying flat on back, hands crossed over abdomen; bring the body to the upright position, then 
rotate from right to left, and from left to right. Place the feet under a pillow or other support 

if necessary. 









228 


Sitting on the floor or other hard surface, feet slightly apart, arms horizontally to the sides; 
rotate to right until the left fingers touch the right toes. (See next illustration.) 











229 



Continuing from preceding exercise now rotate in the opposite direction, touching the left toes 
with the right fingers. Make the movement slow and secure as complete rotation as possible. 

Alternate ten or twelve times to each side. 










230 


Lying flat on the floor, hands clasped behind head, elbows at sides; raise left leg at the same 
time the head and shoulders are raised, and touch the left knee with the right elbow; lower and 

repeat or reverse. Exhale while rising up, inhale while reclining. 












231 




Lying flat on back; first movement, raise shoulders from floor by downward pressure of head 
and vigorous contraction of spinal muscles. In second movement (bottom), have hands in 
position shown; raise hips and shoulders by resting weight on heels, back of head and hands. 







Place the feet on the side of bed with hands on arms of a large heavy rocker-less chair arms 
and body vertical. Or place the feet on the foot of bathtub, the hands on the sides.’ (See 

next illustration.) 















233 


M° v e the body toward the feet, keeping the body vertical and giving considerable pressure by 
the thighs into the abdomen. A small pillow may be placed between the abdomen and the 

thighs to secure greater pressure. 







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234 






First lie on the back, then bring the feet up to touch the 
floor back of the head, or stop in the vertical position and 
perform the bicycle-riding movement with the legs in the 
air. Finish by extending feet back of head, then reclining. 


235 








Lying face down, raise feet and reach back with the hands, grasping the ankles ; now rock for¬ 
ward and backwards in a rocking-chair motion; also sway from side to side. A large pillow 
may be placed beneath the abdomen to secure greater pressure here. 

















Treatment 


The Diaphragm. Direct lung exercises 
will be of value by calling into greater action 
the diaphragm. The effect of this important 
muscle has already been stressed. Reading 
aloud and singing, and vigorous yells where 
opportunity offers, will not only secure direct 
action of this muscle but will stimulate mental 
activity and help to maintain a more optimis¬ 
tic, even youthful mental attitude. Rapid 
deep breathing for a few seconds is good. Or 
the following method will be helpful: take a 
full breath, then take a series of short rapid 
breaths while keeping the lungs well expanded 
—a full-breath panting movement; perform 
the same exercise with the lungs at normal, 
and again with the lungs compressed. This 
will not have the harmful tendency of holding 
the breath, as a small amount of air is inhaled 
rapidly and constantly. Constricting the 
abdomen with the hands while doing this 
exercise will be good also. 

These breathing exercises as well as the 
stationary running, rope-skipping and jump¬ 
ing, and also the body-bending movements, 
may be made more effective by this method: 
drink from one to three or four glasses of 


237 




Constipation 


fairly warm water, then exercise for from 
three to five minutes; drink the same amount 



Showing the diaphragm in exhalation, in which it is 
somewhat flattened; this forces the liver down, also 
the stomach and colon. 


of water again and repeat or vary the exer¬ 
cise; this may be repeated again if desired. 

238 























Treatment 


There will be no objection to continuing the 
exercise up to ten minutes between drinks. 
The average person is inclined to resort to 



Diagrammatically illustrating- the position of the dia¬ 
phragm (made thicker in proportion for better show¬ 
ing) in relation to the lungs and liver during exhala¬ 
tion. Note the diaphragm domed upward. 

methods that are easiest physically, but results 
will be only temporary unless one makes every 
effort to secure a complete return of normal 
tone of muscle, normal nerve impulses and 















Constipation 


normal circulation of blood containing the re¬ 
quired nourishing elements and devoid of toxic 
and other injurious elements. 

Abdominal Massage. Deep massage of 
the abdominal region with the closed hands 
can also be recommended as of value. Tightly 
close the right hand and then, using the other 
hand to add to the pressure, press inward over 
the abdominal region, encircling the abdomen. 
Begin first at the lower left corner of the abdo¬ 
men and make a series of small circles (with¬ 
out removing the hand from the flesh), with 
greatest pressure downward; let these small 
circles gradually approach the lower ribs of 
the left side; then carry them across the abdo¬ 
men, letting the greatest pressure be toward 
the left; when reaching the lower ribs of the 
right side carry the small circles downward to 
the lower right corner of the abdomen, giving 
greatest pressure upward; lighter pressure 
may be given as the circles are carried across 
to the starting point. These small circles mav 
be lepeated several times. Then large circles 
over the abdomen may be made by beginning 
in the lower right-hand corner, bringing the 
pressure upward to the ribs, then across to the 
240 





Illustrating the direction of the massage pressure 
during the individual small circles—heavy pressure 
as shown by the heavy arrows, light pressure by 
the light arrows. Begin at A, complete the descend¬ 
ing colon, across the transverse colon at B, and 
down to C on the ascending colon. 


241 





Constipation 


left ribs and downward to the previous start¬ 
ing point. These movements should be con¬ 
tinued for several minutes daily. If preferred, 
the deep manipulation may be made with the 
finger tips. 

Ball-Massage. A movement more or less 
similar to the massage with the closed hands is 
rolling the abdominal region with a large 
round fairly heavy ball. A ball of from four 
to six pounds in weight and six inches in di¬ 
ameter would be most satisfactory if procur¬ 
able. It may be of any material and may be 
covered, or it may be used over light garments. 
A croquet ball, though small, may be used. 
The same small-circle movement should first 
be taken and then the larger circles. The ob¬ 
jection to such means is that one is consider¬ 
ably more apt to keep his thoughts upon him¬ 
self and his condition, which is decidedly 
undesirable. 

Abdominal Vibration. Vibration of the 
abdomen will help to awaken dormant func¬ 
tions and may easily be accomplished by 
oneself. Lie on the back with the head and 
shoulders supported on a pillow, the ab¬ 
dominal muscles fully relaxed; place the palm 

242 



Treatment 


upon the abdomen, slowly moving in the 
direction of the colon (either from left to right 
or right to left) while as rapidly as possible 
vibrating the hand up and down. The liver 
may be rhythmically agitated in the same man¬ 
ner by placing the palm over the lower ribs. 

Lying on the back and holding the head and 
shoulders slightly from the pillow, to flex the 
abdominal muscles fully, will make possible 
a heavier vibration, secured by lightly pound¬ 
ing over the entire abdominal and liver area 
with the side of the hands or with the closed 
fists. This latter movement should not be 
continued for more than a few seconds at a 
time. 

The effects of the massage, manipulation, 
and vibration are somewhat similar to those of 
exercise, though they can by no means replace 
active exercise, except for those who are bed¬ 
ridden or in other ways physically prevented 
for the time being from taking exercise. 

Kneading the Abdomen at Stool. A 
favorable time for abdominal kneading may 
be while soliciting bowel action. The palm of 
the hand may be placed over the abdomen and 
pressure given alternately from side to side 
243 



Constipation 


and circularly with the heel of the hand and 
the fingers. This will be more effective if one 
drinks a glass or two of water immediately 
before. 

Electricity. Certain types of electrical 
treatment have been used with considerable 
value in constipation. Electricity is supposed 
to produce cell changes and some forms are 
supposed to produce a cell massage more or 
less similar to a gross massage. The sinu¬ 
soidal current with two large electrodes—one 
on the abdomen and the other immediately 
opposite at the back—is considered the most 
beneficial. This produces a contraction of the 
external and internal muscles and the contrac¬ 
tions may be regulated so that they appear 
regularly as in normal peristalsis. The or¬ 
dinary Violet Ray, by experience, has proven 
of little or no benefit. 

Rectal Dilation. Some authorities claim 
that chronic constipation resulting from atony 
is greatly relieved by mechanical dilation of 
the anal sphincters. One form of appliance 
is a rubber bag placed over a hollow hard rub¬ 
ber tube; this is inserted into the rectum and 
then by compressed air at mild pressure the 
244 



Treatment 


bag is somewhat distended. In some cases 
there is added to this a mechanism which 
fairly rapidly but gently vibrates the bag and 
tube. Usually this treatment is possible only 
in a sanitarium and I do not believe the results 
are so favorable that its use may be recom¬ 
mended. Dilation may be secured also by 
hard rubber dilators (which cannot be recom¬ 
mended), or by the fingers. 

HYDROTHERAPY—WATER TREATMENTS 

Many people have been able to correct con¬ 
stipation as well as numerous other physical 
disorders by the use of hydrotherapy alone. 
This is probably usually possible only at the 
beginning of abnormal conditions or before 
they have advanced to a serious degree. There 
are many admirable features of hydrotherapy, 
however, as its medium—water—is universal. 
Water is easily applied direct, or as a means 
of acquiring the desired temperature through 
the use of compresses, packs, etc. It is amen¬ 
able to change to any desired temperature, 
and it may be used in three forms solid, 
liquid and vapor. 

Gold Baths. Cold water is an effective 


245 



Constipation 


means of naturally stimulating the muscula¬ 
ture, nerves, and circulation of the body in 
general or of any particular area. Cold 
sponges to the entire body and especially to 
the abdominal region should be included in a 
regimen adopted for the correction of consti¬ 
pation. Those of lowered vitality may use the 
alternate hot and cold baths, but should al¬ 
ways finish with lowered temperature; and as 
soon as possible the hot should be gradually 
reduced in temperature and duration until the 
cold only can be employed with full immediate 
reaction. 

Sitz Bath. One of the most favorably ef¬ 
fective single methods of using water in 
constipation is the sitz bath, which has a 
marked effect upon the abdominal and pelvic 
organs. A cold sitz bath of from one to three 
minutes daily, or every second day, will be of 
decided value as its effect is tonic upon the 
external muscles, upon the spine and nerves, 
and upon the internal mechanism, because of 
the marked increase in circulation which re¬ 
sults after complete reaction is established. It 
may be necessary for those whose vitality is 
somewhat lowered to use hot sitz baths at first y 


246 



Treatment 


or the hot and cold sitz baths may be alter¬ 
nated two or three times. Some people re¬ 
spond satisfactorily to a fairly prolonged 
warm sitz bath followed by a brisk cold rub, 
splash, or spray with the portable hand spray 
over the immersed parts. Usually thorough 
drying and friction should follow any form of 
bath. 

Natural Bath. Another method of using 
water, that is more or less similar to the sitz 
bath, is that described by Adolph Just, which 
he calls the “natural bath.” Only three or 
four inches of cold water is in the tub in which 
the individual is seated. The water is slowly 
but constantly splashed with the hands over 
the abdomen for thirty seconds; then, as the 
water is escaping from the tub, one leg is 
extended in the water and quickly rubbed 
upward two or three times, then the other leg; 
then one hand quickly splashes the opposite 
arm, and it is splashed in turn; both hands are 
now used to splash the throat and chest; the 
water is then scooped up in the hands and al¬ 
lowed to flow down over the back (if the 
individual has considerable vitality and reac¬ 
tive ability). The bath is finished by rubbing 
247 



Constipation 


the body dry with the hands, or by the usual 
method of drying. This bath is very stimu¬ 
lating and will have a tonic effect upon the 
entire body. In treating constipation the 
complete bath may be omitted and this method 
employed merely to the abdominal area only. 

Shower Bath. Another extremely valu¬ 
able appliance for applying water is the shower 
bath. The average shower bath equipment as 
it is arranged, however, is not so serviceable as 
is the small portable hand shower. I believe 
that for constipation the correct method of 
using this convenience is to sit in the bath tub 
and with the hand spray held at several inches 
from the abdomen allow a fairly forcible cold 
spray to play over the entire abdominal area. 
The spray may be moved slowly or held at 
sufficient distance in order to cover this area. 
A cold spray given in this manner should con¬ 
tinue for only two or three minutes. But a 
fairly hot spray may be given for five minutes, 
followed by a fairly cold spray for a minute or 
two, and alternate in this manner two or three 
times. By this treatment one secures the 
effect of temperature as well as the percussion, 
which has a mild massage effect, derived from 
248 



Treatment 


the force of the water. The water itself has a 
beneficial effect also. Except where there is 
abdominal or pelvic inflammation, drying 
should be vigorous. 

If one is supplied with an over-head shower- 
bath equipment fully installed, it may be pos¬ 
sible to take a treatment similar to that just 
described by reclining beneath the shower. 
The fairly hot bath may be taken in this man¬ 
ner for an hour or two, or longer, as given in 
the “blood-washing” or “Marathon” bath. 
The bowels will usually be relieved of con¬ 
tents, unless extremely constipated, after a 
bath such as this continued for a couple of 
hours. The thin and anemic and those of con¬ 
siderably lowered vitality should avoid such a 
bath except of short duration, say for ten to 
twenty minutes, or when under careful obser¬ 
vation. 

The Enema. Very frequently it is essen¬ 
tial not only to cleanse the bowels at the 
beginning of treatment, but while the function 
is being restored it may be necessary to 
employ some means by which waste material 
can be removed rapidly and regularly enough 
that it may not pollute the blood stream 
249 



Constipation 


through toxic absorption. The usual method 
of accomplishing this cleansing is in the ad¬ 
ministration of drug laxatives, cathartics, and 
purgatives. The final results of such treat¬ 
ment are without exception an increase in the 
disorder. This cleansing can be secured as 
effectively by injections of small quantities of 
water—by the procedure which is known as 
the enema, or colon-flushing—without the 
tendency to perpetuate the constipation. No 
improvement can be suggested upon this 
simple means of temporarily relieving consti¬ 
pated bowels. It is a superior method for 
acute conditions calling for prompt removal 
of all intestinal means of blood contamination 
and, while it is by no means a cure, it is of 
considerable value in numerous chronic con¬ 
ditions, but especially in a chronic state of 
intestinal stasis. 

This method of treatment has been con¬ 
demned by a considerable number of physi¬ 
cians and laymen because of occasional 
undesirable results—and probably by physi¬ 
cians because it places a means of relief in the 
patient’s hands without need of a physician’s 
services. But the undesirable results have 


250 



Treatment 


come from an irrational application of what 
should be a harmless procedure. Large quan¬ 
tities of water injected into the colon and 
retained are very liable to result in chronic 
dilation of this structure, especially if em¬ 
ployed frequently. Still more liable is this 
result to happen where fairly hot water is 
employed, as is frequently done. And the 
greater the force used in injecting the water 
(of whatever temperature), the greater the 
possibility of an over-distention of the colon, 
with a reduction of its elasticity and conse¬ 
quent more or less permanent dilation. 

Very often the injection of but a pint or 
possibly a quart of water, at about body 
temperature (approximately 99 degrees Far- 
enheit), will be sufficient to bring about a 
satisfactory activity of the lower bowel; and 
where this water is allowed to enter slowly by 
the gravity method, with the body in the 
proper position, there can be no danger of an 
undue stretching of the walls of the colon. In 
many cases, however, it is advisable to use a 
small amount of water at either a higher or 
lower temperature; in fact quite hot water; or 
water as low as forty-five degrees may be 
251 



Constipation 


taken safely providing it is quickly expelled, 
reaction is complete, and the method not 
repeated too frequently. 

In employing hot or even very warm enemas 
or enemas of larger quantities of water, a 
small cold enema should be used immediately 
after expelling the first water. This is for the 
purpose of securing a stimulation of the 
nerves and muscles of the rectum in order to 
bring about a contraction of these latter tissues 
so as to overcome the relaxation previously 
produced. A single warm or hot enema, not 
followed by a cold one, would not tend to pro¬ 
duce a permanent relaxation; this is likely to 
occur only where the enema is repeated several 
times. But even in the occasional instance it 
is preferable to secure a contraction of the 
rectal tissues by a small cold enema—say of 
half a pint—in order that the rectum will be 
quick to respond to the stimulus received from 
the next fecal mass. 

I believe in the claim of some that it is not 
ihe hot water itself that does all the damage 
but that this water dissolves bowel contents 
and makes it possible for the toxic elements 
to be absorbed more readily through the villi 
252 



Treatment 


of the intestinal mucous membrane. For this 
reason the higher the temperature of the 
enema water the more quickly should it be 
evacuated after injection, as prolonged reten¬ 
tion of a warm or hot enema may permit the 
absorption of a serious amount of poison. My 
contention is, however, that in addition to this 
effect the hot enema is capable of doing direct 
damage by sufficiently relaxing and dilating 
the tissues that the constipation will be pro¬ 
longed or aggravated. When the cold water 
is used for toning effect it should be allowed 
to escape immediately in order that reaction 
may be more rapid and complete. Also the 
toning effect of this will then be more pro¬ 
nounced. 

In a great number of severe cases of con¬ 
stipation it is advisable to resort immediately 
to the colon-flushing treatment as an initia¬ 
tory and relieving measure. It should he 
remembered that this treatment is merely a 
means for securing temporary relief. I have 
had ample proof of its great value when actu¬ 
ally needed; hut the presence of constipation 
shows that the alimentary canal is not per¬ 
mitted to do its duty, and we must therefore 
253 



Constipation 


trace the cause direct to its origin and try to 
remedy it there rather than to continue at in¬ 
tervals to remove the obstruction—which, as 

already fre¬ 
quently 
stated, is 
often merely 
the result of 
r erne diable 
dietetic and 
hygienic er¬ 
rors. 

Posit i ons 
for the Ene¬ 
ma. In inject¬ 
ing the enema 
one of several 
positions may 
be employed, 
but there are 
only two or 
three that al¬ 
low the water to reach to the full extent of 
the colon. But regardless of the position 
assumed for the injection, the water must he 
admitted slowly. It is highly inadvisable to 
2 54 



Showing the ordinary fountain 
syringe bag, which is the best 
means of giving the enema. 


















Treatment 


use considerable force, as by an enema bag 
suspended at too great a height, or from a tube 
of considerable size. The ordinary fountain 
syringe and tube should be employed, and the 
bag should be suspended at a height of two or 
three feet above the hips. In some cases it 
may be advisable to pinch the tube to slow the 
water. 

The most valuable and effective position is 
what is called the knee-chest position . In 
order to secure this position one stands on his 
knees and then lowers the body forward until 
the elbows or chest or both are on the floor, 
table, mattress, or wherever the enema is to be 
given. The closer that the shoulders can be 
brought to the level of the knees, and the more 
vertical the thighs are kept, the greater the 
incline and consequently the greater the force 
of gravity. In this position the colon is re¬ 
lieved of kinks also, allowing the water to 
reach all parts more easily. While in this 
position the abdomen may be gently kneaded 
or manipulated to ensure the water reaching 
the full length of the descending and trans¬ 
verse colon. This is the preferred position for 
those strong enough, and will be satisfactory 
255 



Constipation 


for all except the bed-ridden and those of 
extreme lowered vitality. 

For these latter cases the position on the 
back with the hips elevated a foot or so above 
the shoulders will prove easier and yet fully 
effective. In this method the thighs are 
drawn up, with the feet resting on the support 
close to the hips. 

There is a combination of positions that may 
be employed. In this method the patient lies 
on the left side, body horizontal or slightly 
sloping downward from hips to head, until 
most of the water is injected; then on the back, 
with the hips raised by pillows or other means, 
and finally on the right side. A glance at the 
illustration of the alimentary tract will show 
how this position allows the water first to 
travel upward in the descending colon, then 
across to the right in the transverse colon, and 
finally downward in the ascending colon. 
This shifting of position is never necessary 
when the knee-chest position is employed. 
When it is used it is a good plan to lie relaxed 
after the water has been injected and give or 
secure from the attendant slow, fairly deep, 
but easy massage of the abdomen in the nat- 
256 



Treatment 


ural direction of the colon. This necessitates 
the holding of the enema for several minutes 
and will therefore not apply when a very 
warm enema is given. 

To Break the Enema Habit. In case one 
has become a victim of the enema or internal 
bath habit, as a result of employing it in an 
injudicious manner, and desires to break from 
the habit it will be necessary to undergo treat¬ 
ment similar to that required for restoring 
bowel tone and function lost from any other 
cause. The fruit diet followed by the milk 
diet will be the most satisfactory treatment, 
even though for a few days or weeks it may 
be necessary to use a half-pint or pint enema 
of cool or tepid water. In fact, whatever 
treatment is used it will frequently be neces¬ 
sary to continue for some time with the enema. 
It will also be equally necessary to reduce the 
amount used and the temperature of the water 
if this formerly was above one hundred de¬ 
grees. The frequency of use must also be 
reduced. 

If the enema has been used twice a day, as 
is sometimes the case, continue this plan for a 
short time but use only one half the amount 
257 



Constipation 


of water formerly used. After a week or so 
discontinue the enema at one end of the day, 
taking it only in the mornings or in the eve¬ 
nings. Later, say after a week or ten days, 
take the enema in the morning of one day and 
in the evening of the next day; then skip one 
day and begin again the following morning; 
in other words, take the injection about every 
thirty-six hours. When possible, change to 
once in forty-eight hours and from then on 
add a day or two to the intermission every 
week, or less if possible, until the enema is dis¬ 
pensed with entirely. 

Follow the same plan in general if the 
enema has been taken but once a day: first 
reducing the amount of water, then lengthen¬ 
ing the interval to thirty-six hours, then to 
forty-eight hours, etc. 

In either case the diet should be somewhat 
laxative in character but not one that sup¬ 
plies sufficient bulk to stretch the already 
dilated colon. If the milk diet is not used, then 
any diet previously recommended for consti¬ 
pation may be followed, providing it contains 
enough of the strengthening foods, as whole 
grain, milk, sweet fruits, and vegetables, to 
258 



Treatment 


add tone to the intestinal musculature, and 
some laxative foods—mildly laxative foods 
being preferable. 

Cleansing of Small Intestines. Where 
the cause is located higher up—in the small 
intestines—the enema procedure would be 
ineffective, as the water of the enema only in 
rare instances can pass upward beyond the 
gate, or (iliocecal) valve, separating the large 
and small intestines. Therefore the best 
means of remedying the trouble in such cases 
would be in the use of those foods and liquids, 
also other hygienic measures, which are in¬ 
clined to accelerate functional activity of the 
stomach and small intestine. The mixture of 
hot water, lemon juice and salt, and the com¬ 
bination of several glasses of water followed 
by exercise and this repeated (these proced¬ 
ures mentioned previously), are very satis¬ 
factory for cleansing the small intestine. 

Oil Injection. Especially in cases of 
spastic constipation the injection of oil into 
the rectum is a very effectual means of giving 
relief. With the patient lying on the back 
with the hips elevated, a pint or more of olive 
oil or cottonseed oil at body temperature may 
259 



Constipation 


be slowly injected; at least fifteen minutes 
should be required for this injection. It should 
be taken at night and the oil retained until 
morning. This may make it necessary to 
apply a loin-cloth so as to prevent oozing of 
the oil during the night. 

If one is troubled with fissures or hemor¬ 
rhoids in addition to constipation, the injec¬ 
tion of an ounce or two of oil at body 
temperature, instead of the larger quantity, 
may be taken at night and retained until 
morning. This is frequently soothing and 
healing, and it lubricates the rectum and the 
rectal contents so that the passages are softer 
and more easily discharged, thus preventing 
greater injury as well as reducing the pain. 

Compresses. A simple treatment that is 
effective in some cases is the use of two or 
three thicknesses of cotton cloth (such as old 
sheeting) wrung from tepid, cool or cold water 
applied to the abdomen and held in place by 
woolen flannel or a waterproof cloth. This 
may be applied at night and allowed to remain 
until morning, though its effect is equally as 
great or greater, when applied in the morning 
and retained the first half of the day. The 
260 



Treatment 


immediate temperature of the compress is of 
no great consequence, except that the colder 
it is when applied the greater will be the reac¬ 
tion when warmth is established. The body 
heat soon increases the temperature of the 
compress and it is the moist heat which has the 
tonic effect. 

Plug-Removal in Impaction. In the 

emergency treatment of impaction that some¬ 
times occurs either chronically or acutely in 
constipation, it is necessary that the plug be 
removed as quickly and completely yet as 
easily as possible. I have known a number of 
people, especially nervous women, to become 
hysterical as a result of this impaction. There 
is no occasion for such extreme excitement 
and it really aggravates the condition and 
makes it more difficult to secure relief, because 
of the increased tension and contraction of the 
rectal sphincters which it produces. 

A small douche tip on a fountain syringe 
tubing may be oiled and gently inserted into 
the rectum alongside of the plug; fairly warm 
water flowing from this syringe tip usually 
will slowly disintegrate the plug and allow it 
to pass piece by piece. In some cases this is 
261 



Constipation 


not effective; here it is better to use warm oil, 
either sweet oil or castor oil. This may very 
quickly secure results, or the oil may have to 
be retained for some time. The patient should, 
if possible, be in the “natural posture” (seated 
in the squat position, to be mentioned later), 
and should be making gentle straining effort. 
The rectum may be oiled in order to lubricate 
it and assist it to relax better. 

If this does not secure relief then the oil 
should be injected, the rectum lubricated 
externally as well as internally, and an oiled 
finger, small spoon handle, or special “scoop” 
inserted and gently used to break up the fecal 
mass. After this has been discharged, oil 
should be injected and allowed to remain for 
soothing the irritated membrane and making 
the next passage more assured and easier. 

In some of the cases that lead to impaction, 
drugs, mineral waters, laxative foods, etc., 
have been consumed for the purpose of bring¬ 
ing about evacuation. After the plug has been 
removed a surprising amount of retained 
liquid substances may come forth in a veritable 
freshet of scalding, foul-smelling toxic mater¬ 
ial. This may produce extreme irritation of 
262 



Treatment 


the rectum. After the discharge has subsided, 
a cleansing enema should be used, then a small 
amount of oil injected and retained. Then see 
that in the future there is no long retention 
of waste matter in the colon to result in impac¬ 
tion. People who are subject to impaction 
will find the small enema a positive preventive. 

ASSOCIATE TREATMENT FACTORS 

Spinal Friction and Massage. Daily 
friction with the hands or a coarse towel from 
one extremity of the spine to the other, but 
especially from the middle of the back down¬ 
ward, will help to tone up the nerves of the 
spine controlling digestion and bowel action. 
This friction should continue for five minutes 
or longer. Massage to this area will have still 
greater effect. 

Spinal Manipulation. In numerous cases 
the spinal muscles and ligaments are so con¬ 
tracted, as a result of accidents, injuries, jars, 
strains, cold, posture (especially occupational 
posture), etc., that special manipulative treat¬ 
ment such as Naprapathic, Osteopathic, 
Swedish Manual, Mechanical Physcultopathy 
and Mechanotherapy are of great value in 
263 



Constipation 


bringing about relaxation and more normal 
nerve action and tone of these structures. 
Proper slow bending and rotation of the trunk 
will have this stretching and relaxing effect to 
some extent. In a few in¬ 
stances a spinal vertebra 
may be slightly out of align¬ 
ment with the adj acent ver¬ 
tebrae, in which Chiroprac¬ 
tic treatment 
will be of value, 
though the 
other forms ; of 
inanipu- 
1 a t i o n 
just men¬ 
tioned us¬ 
ually will 
correct 
this con- 
d i t i o n 
also. 

Posture. Civilization is responsible for 
man’s present unnatural posture while evac¬ 
uating the bowel waste. This position on a 
high toilet seat places the thighs horizontal 

264 



Showing the simple means for securing 
the natural position during defacation or 
bowel movements, the feet to be placed 
on the stool in front of the toilet seat. 








Treatment 


and the trunk usually vertical or at most 
slightly diagonally forward, which is not con¬ 
ducive to free evacuation. The natural pos¬ 
ture is the squatting position, with the trunk 
vertical and the thigh practically so. Such a 
posture has a tendency to straighten the kinks 
of the sigmoid and rectum and to secure 
greater direct pressure upon the colon and its 
contents. And, because of the contracted 
abdominal area, the effect of the diaphragm’s 
contraction is more marked. A lessening of 
the extent of constipation would be secured, I 
believe, if the toilet seats were much lower or 
if a step for the feet were placed sufficiently 
high to bring about the natural position of the 
body while seated. A partially similar effect 
may be secured on the average toilet stool by 
leaning far forward. It may be advisable, in 
some instances, to lean forward with the arms 
folded between the thighs and the abdomen. 

Comfort Privies. In rural districts the 
exposed and unsheltered privies are a fruitful 
source of constipation and are extremely unfit 
and inappropriate for the satisfactory cure of 
the condition. Especially is this true in the 
cases of delicate women. Wherever possible 


2 65 



Constipation 


care should be taken that the water closet is 
made easily accessible and that it be made 
comfortable so far as warmth is concerned. 
When one is combatting constipation, espe¬ 
cially by the solicitation method, it is doubtful 
if results will be satisfactory if one is shivering 
and contracted from cold. The exposed 
privies should be made wind proof, even with a 
coating of tar paper if necessary. A venti¬ 
lating device should be provided to carry off 
the odors and make the privies more comfort¬ 
able during hot weather. 

Suppositories. ' I do not believe that sup¬ 
positories are necessary in any case where diet, 
exercise, and other relieving factors are prop¬ 
erly used. But these may be employed in the 
case of impatient individuals who are inclined 
to resort to even more undesirable means of 
relief if results are not fairly prompt. Small* 
glycerine or gluten suppositories may be in¬ 
serted into the rectum, where they exert a 
lubricating or mildly stimulating effect. 
However, they are not curative and should not 
be relied upon to the exclusion of corrective 
gleans. 


266 



Treatment 


Medication. This form of treatment will 
not be mentioned save to condemn it. Enough 
has been previously said about this artificial, 
unnatural, provocative treatment that any 
reader who has read this far and still believes 
in their efficiency and resorts to it is be¬ 
yond conviction of the harm of drugs and of 
the efficacy of natural means. Such an one 
should consult one who will willingly pre¬ 
scribe the desired drug-laxatives, cathartics, 
and purgatives. 

Surgery. As previously stated, surgery 
should never be employed for the relief of con¬ 
stipation alone. Occasionally there may be 
some organic or structural defect or malform- 
ity that may call for surgical relief, but only 
in these should surgery be employed. In my 
opinion the removal of a part of the colon for 
the relief of constipation is one of the most 
pronounced expressions of rankest ignorance 
that has ever been manifested by the medical 
profession. While I most heartily condemn 
drug treatment I consider it mild in its direct 
and potential injurious effects as compared to 
the removal of a most vital part of the 
anatomy. 


267 



Constipation 


Even conditions producing constipation 
which are considered incurable by the internist 
or the surgeon may be fairly easily correctible 
by rational treatment if it be given a conscien¬ 
tious trial. 

Constipation can be cured only through 
means which usually must be fairly slow in 
securing results. I have already emphasized 
the importance of materially toning up 
muscles, mucous membrane and nerves of the 
intestines themselves, of improving the quality 
and local as well as general circulation of the 
blood, and strengthening the external muscles, 
especially those of the abdomen. Any method 
of treatment which does not have these effects 
as its aim and result is temporary in relief 
given, and by no means curative. 

A large variety of treatment has been given 
in this book, since what will correct constipa¬ 
tion in many cases may not in all others. The 
general procedure or plan of treatment must 
be the same in the majority of cases, but in 
minor points there may be required consider¬ 
able variation. Exercise of the abdominal 
muscles may be sufficient in a few cases; gen- 
268 



Treatment 


eral exercise in others; a slight correction of 
diet alone in still other cases, and so on. But 
even in the cases relieved by diet alone, the 
articles of food and their combinations must 
differ in individual instances. Therefore the 
several natural methods of correction enumer¬ 
ated have been given so that victims of con¬ 
stipation, of whatever nature and degree, 
except the strictly surgical cases (which are 
extremely rare), may choose that which will 
secure results in their individual cases. No 
one can select in detail, with absolute certainty 
of results, a complete regimen that will serve 
for every individual. A detailed regimen 
may be effective in ninety-five cases out of one 
hundred, but the other five will require modifi¬ 
cation; it is for the few as well as for the 
majority that all methods have been given. 
When we learn how to feed, water and exer¬ 
cise the body we shall have no more constipa¬ 
tion; but until that time we must resort to 
“cures.” Choose that “cure” which is least 
harmful, and adhere to it until desired results 
are secured. 


269 



Constipation 


SUMMARY 

It will be of convenience to the reader and 
it will obviate any possibility of confusion as 
to what course to pursue in remedying consti¬ 
pation to summarize briefly the instructions 
presented in this volume. 

There are certain things which must or 
should be done in all cases; these are: 

1. Obey the call to relieve the bowels 
whenever this occurs, regardless of how 
slight the call may be. 

2. Empty the lower bowel at regular in¬ 
tervals when eating regularly. 

3. Solicit the bowels regularly, at least 
once a day. 

4. Drink sufficient water, preferably nat¬ 
urally cold, daily. 

5. Avoid unwholesome and constipating 
foods, and those having an excessive 
laxative effect. 

6. Use more or less foods known to be 
laxative and the remainder those known 
to be neutral in their action. 

7. Masticate all foods thoroughly. 

270 



Treatment 


8. Exercise for general body develop¬ 
ment, tone and invigoration. 

9. Exercise particularly the abdominal 
region and in the manner illustrated in 
numerous special exercises. 

10. Special emergency measures should be 
used when needed, but only when 
needed. When employed, discontinue 
the most pronouncedly effective as soon 
as possible without relapse. 

11. In general, a hygienic mode of living 
must he adopted to improve constitu¬ 
tional health and vigor. 

In addition to these, the adoption of a 
sjiecial diet may be a most important factor. 
Whatever the diet selected, except the exclu¬ 
sive milk diet, the regimen just enumerated 
must be adopted. There are at least three 
systems of diet that may be employed. 

1. One will consist of the exclusive milk 
diet following a short fast. When following 
this diet the amount of exercise will neces¬ 
sarily be reduced in a few cases of extreme 
lowered vitality, with weakness and functional 
disorders of the digestive system; it might be 
well for such cases to avoid all exercise until 


271 



Constipation 


improvement has been made. But in almost 
all cases more or less exercise can be taken, in 
bed if necessary. As to the nature of exercise, 
each case is a law unto itself, regardless of 
what diet is employed; but walking should be 
one exercise used by everyone able to stand 
on bis feet. The milk diet is described on 
pages 153 to 156. 

2. A correction of the diet in the second 
regimen must be made to include natural 
foods, though prepared in the conventional 
manner; that is, two or three meals a day may 
be taken of the usual foods, with special em¬ 
phasis upon those that give greater vitality 
and that are non-constipating—with some of 
the recognized laxative foods. These foods 
are enumerated on pages 157 to 159. 

3. The diet to be followed here is the un¬ 
cooked diet. This regimen may be adopted 
in stubborn cases where ordinary dietetic 
regulations as required by regimen Number 2 
fail to secure results or where regimen Number 
1 is for any reason impossible to follow. For 
instructions in regard to the uncooked diet see 
pages 161 to 164. 


272 



Treatment 


CONSTIPATION IN CHILDREN 

A word in regard to constipation in chil¬ 
dren should be of value. Children are usually 
so active that they keep their muscular system 
in fairly good tone and their various functions 
fairly normal. It is this activity which pre¬ 
vents them from having more serious troubles 
than they do, as their diet is usually radically 
wrong, because parents do not give this sub¬ 
ject the consideration it requires. Too much 
candy, jams and jellies and other sweets; too 
much potatoes and gravy, pastries and white 
flour products, and other clogging, unwhole¬ 
some foods, and the universal piece-mealing 
are all responsible for constipation in a large 
number of children. Another frequent cause 
is lack of training and insistence upon regular 
habits. From their earliest years children 
should be trained in regular habits; this, to¬ 
gether with the proper diet, will usually save 
them from constipation. 

When they desire and require anything be¬ 
tween meals children should be given fruit. 
This will not only not interfere with appetite 
and the digestion of meals but it will in itself 
273 



Constipation 


be preventive or corrective of constipation. 
Children’s desire for sweets should be satis¬ 
fied, but not by candy, sugar, and sugar prod¬ 
ucts; sweet fruits and a small amount of 
honey will fully satisfy their “sweet tooth” and 
their system’s demand for this element, at the 
same time supplying genuine nourishment. 

Care should be taken that the food is not 
bolted, that it is not washed down, and that it 
is not taken in excessive amounts. The 
natural foods mentioned on page 162 will 
usually be more thoroughly enjoyed by the 
children than the usual unnatural foods they 
receive, if they are trained early to use them; 
and these foods will be naturally laxative, as 
well. 

The constipation of nursing children may 
require the direct personal care of some physi¬ 
cian, but the ordinary case will respond with¬ 
out any personal attention except intestinal 
cleanliness and temporary rest. If the health of 
the mother is looked after, if she is careful to 
use the most strictly wholesome diet possible 
and to follow the rules of hygiene, the milk 
she provides for the baby will probably be suf¬ 
ficiently laxative. The average nursing 
274 



Treatment 


mother avoids most fruits, fearing they will 
cause colic or other troubles in the baby fed 
from the breast. This idea should be dis¬ 
carded for such foods may prevent or cure 
constipation or other troubles in the child. 
Too early inclusion of starch in the diet is the 
most frequent cause of constipation in babies 
of five to seven months. 

Many babies do not secure enough drinking 
water. This in itself is all that some of them 
require to keep the bowels normal. In some 
cases it may be necessary to give a small 
amount of strained orange juice in the drink¬ 
ing water of the infant, or from teaspoonful 
to tablespoonful doses may be given plain and 
undiluted. From one to two tablespoonfuls 
of the strained juice may be added to six 
ounces of water and as much of this as the 
child will take may be allowed two or three 
times a day. Unaltered water may be allowed 
as often as the child will take it; if this water 
is naturally hard it should be boiled or dis¬ 
tilled, then aerated. Some of the slighter cases 
of constipation can be corrected and in some 
instances constipation may be prevented en¬ 
tirely by small amounts of thin strained barley 
275 




Constipation 


water or oatmeal gruel once or twice a day. 
There should be none of the solid substance of 
the cereal in these thin drinks. 

A small conical piece of pure castile soap, 
immersed in oil and inserted into the rectum, 
will take care of practically all other cases of 
constipation in infants, and sometimes in older 
children. Slight, gentle massage in the re¬ 
verse direction of the colon or a small injection 
of cool or tepid water will prove very effective 
as emergency or quick relief. Whatever 
method is employed for children it will be 
necessary to avoid anything that will injure 
the more delicate organs in their immature 
state. All agents must be used in greater 
moderation for them than for adults. It is 
surprising how quickly children respond to 
rational treatment for constipation, or for any 
other abnormal condition, and they require 
less effort to keep them in health—if a natural, 
strictly hygienic regimen is adopted for them. 
But because their systems are more responsive 
to either health- or disease-producing influ¬ 
ences, a condition that would be productive of 
no great harm in an adult may produce sud¬ 
den and serious or even fatal effects upon a 
276 



Treatment 


child. Therefore, as constipation is so harm¬ 
ful in the adult, it may be a serious thing for 
an infant or for a child of any age. The same 
thing holds for them as for an adult, only a 
great deal more so—an ounce of prevention is 
worth a pound of cure. 


[the end] 


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